Sainan Cheng1, Mengjie Fang2,3, Chen Cui1, Xiuyu Chen1, Gang Yin1, Sanjay K Prasad4, Di Dong5,6, Jie Tian2,3, Shihua Zhao7. 1. Department of Cardiac MR, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, No. 167 Beilishi Road, Beijing, 100037, China. 2. CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, No. 95 East Zhongguancun Road, Beijing, 100190, China. 3. University of Chinese Academy of Sciences, Beijing, 100049, China. 4. Cardiovascular Magnetic Resonance Unit, NIHR Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK. 5. CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, No. 95 East Zhongguancun Road, Beijing, 100190, China. di.dong@ia.ac.cn. 6. University of Chinese Academy of Sciences, Beijing, 100049, China. di.dong@ia.ac.cn. 7. Department of Cardiac MR, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, No. 167 Beilishi Road, Beijing, 100037, China. cjrzhaoshihua2009@163.com.
Abstract
OBJECTIVES: To evaluate the prognostic value of texture features based on late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) images in hypertrophic cardiomyopathy (HCM) patients with systolic dysfunction. METHODS: 67 HCM patients with systolic dysfunction (41 male and 26 female, mean age ± standard deviation, 46.20 years ± 13.38) were enrolled. All patients underwent 1.5 T CMR cine and LGE imaging. Texture features were extracted from LGE images. Cox proportional hazard analysis and Kaplan-Meier analysis were used to determine the association of texture features and traditional parameters with event free survival. RESULTS: Family history (hazard ratio [HR]=2.558, 95 % confidence interval [CI]=1.060-6.180), NYHA III-IV (HR=5.627, CI=1.652-19.173), left ventricular ejection fraction (HR=0.945, CI=0.902-0.991), left ventricular end-diastolic volume index (HR=1.006, CI=1.000-1.012), LGE extent (HR=1.911, CI=1.348-2.709) and three texture parameters [X0_H_skewness (HR=0.783, CI=0.691-0.889), X0_GLCM_cluster_tendency (HR=0.735, CI=0.616-0.877) and X0_GLRLM_energy (HR=1.344, CI=1.173-1.540)] were significantly associated with event free survival in univariate analysis (p<0.05). The HR of LGE extent (HR=1.548 [CI=1.046-2.293], 1.650 [CI=1.122-2.428] and 1.586 [CI=1.044-2.409] per 10 % increase, p<0.05) remained significant when adjusted by one of the three texture features. CONCLUSION: Increased LGE heterogeneity (higher X0_GLRLM_energy, lower X0_H_skewness and lower X0_GLCM_cluster_tendency) was associated with adverse events in HCM patients with systolic dysfunction. KEY POINTS: • Textural analysis from CMR can be applied in HCM. • Texture features derived from LGE images can capture fibrosis heterogeneity. • CMR texture analysis provides prognostic information in HCM patients.
OBJECTIVES: To evaluate the prognostic value of texture features based on late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) images in hypertrophic cardiomyopathy (HCM) patients with systolic dysfunction. METHODS: 67 HCM patients with systolic dysfunction (41 male and 26 female, mean age ± standard deviation, 46.20 years ± 13.38) were enrolled. All patients underwent 1.5 T CMR cine and LGE imaging. Texture features were extracted from LGE images. Cox proportional hazard analysis and Kaplan-Meier analysis were used to determine the association of texture features and traditional parameters with event free survival. RESULTS: Family history (hazard ratio [HR]=2.558, 95 % confidence interval [CI]=1.060-6.180), NYHA III-IV (HR=5.627, CI=1.652-19.173), left ventricular ejection fraction (HR=0.945, CI=0.902-0.991), left ventricular end-diastolic volume index (HR=1.006, CI=1.000-1.012), LGE extent (HR=1.911, CI=1.348-2.709) and three texture parameters [X0_H_skewness (HR=0.783, CI=0.691-0.889), X0_GLCM_cluster_tendency (HR=0.735, CI=0.616-0.877) and X0_GLRLM_energy (HR=1.344, CI=1.173-1.540)] were significantly associated with event free survival in univariate analysis (p<0.05). The HR of LGE extent (HR=1.548 [CI=1.046-2.293], 1.650 [CI=1.122-2.428] and 1.586 [CI=1.044-2.409] per 10 % increase, p<0.05) remained significant when adjusted by one of the three texture features. CONCLUSION: Increased LGE heterogeneity (higher X0_GLRLM_energy, lower X0_H_skewness and lower X0_GLCM_cluster_tendency) was associated with adverse events in HCM patients with systolic dysfunction. KEY POINTS: • Textural analysis from CMR can be applied in HCM. • Texture features derived from LGE images can capture fibrosis heterogeneity. • CMR texture analysis provides prognostic information in HCM patients.
Entities:
Keywords:
Cardiac magnetic resonance; Event-free survival; Hypertrophic cardiomyopathy; Late gadolinium enhancement; Texture features
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