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Zhang TY, An DA, Zhou H, Ni Z, Wang Q, Chen B, Lu R, Huang J, Zhou Y, Kim DH, Wilson M, Wu LM, Mou S. Texture analysis of native T1 images as a novel method for non-invasive assessment of heart failure with preserved ejection fraction in end-stage renal disease patients. Eur Radiol 2023; 33:2027-2038. [PMID: 36260118 DOI: 10.1007/s00330-022-09177-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/09/2022] [Accepted: 09/15/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To explore the diagnostic potential of texture analysis applied to native T1 maps obtained from cardiac magnetic resonance (CMR) images for the assessment of heart failure with preserved ejection fraction (HFpEF) among patients with end-stage renal disease (ESRD). METHODS This study, conducted from June 2018 to November 2020, included 119 patients (35 on hemodialysis, 55 on peritoneal dialysis, and 29 with kidney transplants) in Renji Hospital. Native T1 maps were assessed with texture analysis, using a freely available software package, in participants who underwent cardiac MRI at 3.0 T. Four texture features, selected by dimension reduction specific to the diagnosis of HFpEF, were analyzed. Multivariate logistic regression was performed to examine the independent association between the selected features and HFpEF in ESRD patients. RESULTS Seventy-six of 119 patients were diagnosed with HFpEF. Demographic, laboratory, cardiac MRI, and echocardiogram characteristics were compared between HFpEF and non-HFpEF groups. The four texture features that were analyzed showed statistically significant differences between groups. In multivariate analysis, age, left atrial volume index (LAVI), and sum average 4 (SA4) turned out to be independent predictors for HFpEF in ESRD patients. Combining the texture feature, SA4, with typical predictive factors resulted in higher C-index (0.923 vs. 0.898, p = 0.045) and a sensitivity and specificity of 79.2% and 95.2%, respectively. CONCLUSIONS Texture analysis of T1 maps adds diagnostic value to typical clinical parameters for the assessment of heart failure with preserved ejection fraction in patients with end-stage renal disease. KEY POINTS • Non-invasive assessment of HFpEF can help predict prognosis in ESRD patients and help them take timely preventative measures. • Texture analysis of native T1 maps adds diagnostic value to the typical clinical parameters for the assessment of HFpEF in patients with ESRD.
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Affiliation(s)
- Tian-Yi Zhang
- Department of Nephrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, People's Republic of China
| | - Dong-Aolei An
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, People's Republic of China
| | - Hang Zhou
- Department of Nephrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, People's Republic of China
| | - Zhaohui Ni
- Department of Nephrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, People's Republic of China
| | - Qin Wang
- Department of Nephrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, People's Republic of China
| | - Binghua Chen
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, People's Republic of China
| | - Renhua Lu
- Department of Nephrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, People's Republic of China
| | - Jiaying Huang
- Department of Nephrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, People's Republic of China
| | - Yin Zhou
- Department of Nephrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, People's Republic of China
| | - Doo Hee Kim
- Department of Radiology, Wayne State University, Detroit, MI, 48201, USA
| | - Molly Wilson
- Department of Radiology, Wayne State University, Detroit, MI, 48201, USA
| | - Lian-Ming Wu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, People's Republic of China.
| | - Shan Mou
- Department of Nephrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, People's Republic of China.
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Sultan FAT, Saadia S. Patterns of Left Ventricular Hypertrophy and Late Gadolinium Enhancement on Cardiac MRI in Patients with Hypertrophic Cardiomyopathy and their Prognostic Significance - An Experience from a South Asian Country. J Clin Imaging Sci 2021; 11:14. [PMID: 33767906 PMCID: PMC7981941 DOI: 10.25259/jcis_235_2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 02/17/2021] [Indexed: 11/04/2022] Open
Abstract
Objectives Cardiac magnetic resonance (CMR) imaging is very pertinent in the diagnosis and risk stratification of patients with hypertrophic cardiomyopathy (HCM). We aimed to assess the patterns of left ventricular (LV) hypertrophy, late gadolinium enhancement (LGE), and their prognostic significance in HCM patients in Pakistani population, as no such data are available from Pakistan. Material and Methods This was a retrospective, single center study. All patients who had confirmed diagnosis of HCM on CMR at Aga Khan University Hospital during the period of 2011-2019 were identified and included in the study. Results A total of 74 patients were included with the mean age of 45.6 ± 15 years and the majority 71.6 % (n = 53) being male. Maximal LV wall thickness was 21.1 ± 5 mm, asymmetrical septal hypertrophy being the most common pattern (62.2%, n = 46). LGE was present in 75.7% (n = 56) with most common site being septum plus LV free wall (24.3%, n =18). Mean ejection fraction% was found to be lower in patients with LGE (P < 0.001). Major adverse cardiac events (MACE) were observed in 40.5% (n = 30). Presence of LGE and right ventricular involvement was found to have a statistically significant association with MACE (P value 0.018 and 0.046, respectively). In multivariable analysis, only LGE was significantly associated with MACE (odd ratio: 4.65; 95% CI: 1.21-17.88). Conclusion Asymmetrical septal hypertrophy was the most common pattern of hypertrophy. LGE was present in three fourth of the study population and it was significantly associated with MACE.
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Affiliation(s)
| | - Sheema Saadia
- Department of Medicine, Aga Khan University Hospital, Karachi, Sindh, Pakistan
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Maron BJ, Maron MS. The Remarkable 50 Years of Imaging in HCM and How it Has Changed Diagnosis and Management: From M-Mode Echocardiography to CMR. JACC Cardiovasc Imaging 2017; 9:858-872. [PMID: 27388665 DOI: 10.1016/j.jcmg.2016.05.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 05/02/2016] [Accepted: 05/12/2016] [Indexed: 11/28/2022]
Abstract
The almost 50-year odyssey of cardiac imaging in hypertrophic cardiomyopathy (HCM), revisited and described here, has been remarkable, particularly when viewed in the timeline of advances that occurred during a single generation of investigators. At each step along the way, from M-mode to 2-dimensional echocardiography to Doppler imaging, and finally over the last 10 years with the emergence of high-resolution tomographic cardiac magnetic resonance (CMR), evolution of the images generated by each new technology constituted a paradigm change over what was previously available. Together, these advances have transformed the noninvasive diagnosis and management of HCM in a number of important clinical respects. These changes include a more complete definition of the phenotype, resulting in more reliable clinical identification of patients and family members, defining mechanisms (and magnitude) of left ventricular outflow obstruction, and novel myocardial tissue characterization (including in vivo detection of fibrosis/scarring); notably, these advances afford more precise recognition of at-risk patients who are potential candidates for life-saving primary prevention defibrillator therapy. This evolution in imaging as applied to HCM has indelibly changed cardiovascular practice for this morphologically and clinically complex genetic disease.
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Affiliation(s)
- Barry J Maron
- Hypertrophic Cardiomyopathy Institute, Tufts Medical Center, Division of Cardiology, Boston, Massachusetts.
| | - Martin S Maron
- Hypertrophic Cardiomyopathy Institute, Tufts Medical Center, Division of Cardiology, Boston, Massachusetts
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Noureldin RA, Liu S, Nacif MS, Judge DP, Halushka MK, Abraham TP, Ho C, Bluemke DA. The diagnosis of hypertrophic cardiomyopathy by cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2012; 14:17. [PMID: 22348519 PMCID: PMC3309929 DOI: 10.1186/1532-429x-14-17] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Accepted: 02/20/2012] [Indexed: 12/31/2022] Open
Abstract
Hypertrophic cardiomyopathy (HCM) is the most common genetic disease of the heart. HCM is characterized by a wide range of clinical expression, ranging from asymptomatic mutation carriers to sudden cardiac death as the first manifestation of the disease. Over 1000 mutations have been identified, classically in genes encoding sarcomeric proteins. Noninvasive imaging is central to the diagnosis of HCM and cardiovascular magnetic resonance (CMR) is increasingly used to characterize morphologic, functional and tissue abnormalities associated with HCM. The purpose of this review is to provide an overview of the clinical, pathological and imaging features relevant to understanding the diagnosis of HCM. The early and overt phenotypic expression of disease that may be identified by CMR is reviewed. Diastolic dysfunction may be an early marker of the disease, present in mutation carriers prior to the development of left ventricular hypertrophy (LVH). Late gadolinium enhancement by CMR is present in approximately 60% of HCM patients with LVH and may provide novel information regarding risk stratification in HCM. It is likely that integrating genetic advances with enhanced phenotypic characterization of HCM with novel CMR techniques will importantly improve our understanding of this complex disease.
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MESH Headings
- Cardiomyopathy, Hypertrophic, Familial/complications
- Cardiomyopathy, Hypertrophic, Familial/diagnosis
- Cardiomyopathy, Hypertrophic, Familial/genetics
- Cardiomyopathy, Hypertrophic, Familial/pathology
- Cardiomyopathy, Hypertrophic, Familial/physiopathology
- Contrast Media
- Death, Sudden, Cardiac/etiology
- Disease Progression
- Fibrosis
- Genetic Predisposition to Disease
- Humans
- Hypertrophy, Left Ventricular/diagnosis
- Hypertrophy, Left Ventricular/genetics
- Hypertrophy, Left Ventricular/physiopathology
- Magnetic Resonance Imaging
- Myocardium/pathology
- Phenotype
- Predictive Value of Tests
- Prognosis
- Ventricular Function, Left
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Affiliation(s)
- Radwa A Noureldin
- Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Songtao Liu
- Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD, USA
- Molecular Biomedical Imaging Laboratory, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - Marcelo S Nacif
- Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Daniel P Judge
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Marc K Halushka
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - Theodore P Abraham
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Carolyn Ho
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA
| | - David A Bluemke
- Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD, USA
- Molecular Biomedical Imaging Laboratory, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
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