CardioMOD-Net: A Modal Decomposition-Neural Network Framework for Diagnosis and Prognosis of HFpEF from Echocardiography Cine Loops

Introduction: Heart failure with preserved ejection fraction (HFpEF) arises from diverse comorbidities and progresses through prolonged subclinical stages, making early diagnosis and prognosis difficult. Current echocardiography-based Artificial Intelligence (AI) models focus primarily on binary HFpEF detection in humans and do not provide comorbidity-specific phenotyping or temporal estimates of disease progression towards decompensation. We aimed to develop a unified AI framework, CardioMOD-Net, to perform multiclass diagnosis and continuous prediction of HFpEF onset directly from standard echocardiography cine loops in preclinical models. Methods: Mouse echocardiography videos from four groups were used: control (CTL), hyperglycaemic (HG), obesity (OB), and systemic arterial hypertension (SAH). Two-dimensional parasternal long-axis cine loops were decomposed using Higher Order Dynamic Mode Decomposition (HODMD) to extract temporal features for downstream analysis. A shared latent representation supported Vision Transformers, one for a classifier for diagnosis and another for a regression module for predicting the age at HFpEF onset. Results: Overall diagnostic accuracy across the four groups was 65%, with all classes exceeding 50% accuracy. Misclassifications primarily reflected early-stage overlap between OB or SAH and CTL. The prognostic module achieved a root-mean-square error of 21.72 weeks for time-to-HFpEF prediction, with OB and SAH showing the most accurate estimates. Predicted HFpEF onset closely matched true distributions in all groups. Discussion: This unified framework demonstrates that multiclass phenotyping and continuous HFpEF onset prediction can be obtained from a single cine loop, even under small-data conditions. The approach offers a foundation for integrating diagnostic and prognostic modelling in preclinical HFpEF research.