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Chen YC, Zheng J, Zhou F, Tao XW, Chen Q, Feng Y, Su YY, Zhang Y, Liu T, Zhou CS, Tang CX, Weir-McCall J, Teng Z, Zhang LJ. Coronary CTA-based vascular radiomics predicts atherosclerosis development proximal to LAD myocardial bridging. Eur Heart J Cardiovasc Imaging 2024; 25:1462-1471. [PMID: 38781436 DOI: 10.1093/ehjci/jeae135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 05/09/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
AIMS Cardiac cycle morphological changes can accelerate plaque growth proximal to myocardial bridging (MB) in the left anterior descending artery (LAD). To assess coronary computed tomography angiography (CCTA)-based vascular radiomics for predicting proximal plaque development in LAD MB. METHODS AND RESULTS Patients with repeated CCTA scans showing LAD MB without proximal plaque in index CCTA were included from Jinling Hospital as a development set. They were divided into training and internal testing in an 8:2 ratio. Patients from four other tertiary hospitals were set as external validation set. The endpoint was proximal plaque development of LAD MB in follow-up CCTA. Four vascular radiomics models were built: MB centreline (MB CL), proximal MB CL (pMB CL), MB cross-section (MB CS), and proximal MB CS (pMB CS), whose performances were evaluated using area under the receiver operating characteristic curve (AUC), integrated discrimination improvement (IDI), and net reclassification improvement (NRI). In total, 295 patients were included in the development (n = 192; median age, 54 ± 11 years; 137 men) and external validation sets (n = 103; median age, 57 ± 9 years; 57 men). The pMB CS vascular radiomics model exhibited higher AUCs in training, internal test, and external sets (AUC = 0.78, 0.75, 0.75) than the clinical and anatomical model (all P < 0.05). Integration of the pMB CS vascular radiomics model significantly raised the AUC of the clinical and anatomical model from 0.56 to 0.75 (P = 0.002), along with enhanced NRI [0.76 (0.37-1.14), P < 0.001] and IDI [0.17 (0.07-0.26), P < 0.001] in the external validation set. CONCLUSION The CCTA-based pMB CS vascular radiomics model can predict plaque development in LAD MB.
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Affiliation(s)
- Yan Chun Chen
- Department of Radiology, Jinling Hospital, Nanjing Medical University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu 210002, China
| | - Jin Zheng
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Fan Zhou
- Department of Radiology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu 210002, China
| | | | - Qian Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210002, China
| | - Yun Feng
- Department of Radiology, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu 223001, China
| | - Yun Yan Su
- Department of Radiology, The First Affiliated Hospital of Soochow University, 188 Shizi Road, Gusu District, Suzhou, Jiangsu 215006, China
| | - Yu Zhang
- Outpatient Department of Military, The 901st Hospital of the Joint Logistics Support Force of PLA, Hefei 230031, China
| | - Tongyuan Liu
- Department of Radiology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, Jiangsu 210002, China
| | - Chang Sheng Zhou
- Department of Radiology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu 210002, China
| | - Chun Xiang Tang
- Department of Radiology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu 210002, China
| | - Jonathan Weir-McCall
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Royal Papworth Hospital, Cambridge, UK
| | - Zhongzhao Teng
- Nanjing Jingsan Medical Science and Technology, Ltd., Nanjing, Jiangsu, China
| | - Long Jiang Zhang
- Department of Radiology, Jinling Hospital, Nanjing Medical University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu 210002, China
- Department of Radiology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu 210002, China
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Freidoonimehr N, Chin R, Zander A, Arjomandi M. A Review on the Effect of Temporal Geometric Variations of the Coronary Arteries on the Wall Shear Stress and Pressure Drop. J Biomech Eng 2021; 144:1115053. [PMID: 34318321 DOI: 10.1115/1.4051923] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Indexed: 11/08/2022]
Abstract
Temporal variations of the coronary arteries during a cardiac cycle are defined as the superposition of the changes in the position, curvature, and torsion of the coronary artery axis markers and the variations in the lumen cross-sectional shape due to the distensible wall motion induced by the pulse pressure and contraction of the myocardium in a cardiac cycle. This review discusses whether modeling of the temporal variations of the coronary arteries is needed for the investigation of hemodynamics specifically in time-critical applications such as a clinical environment. The numerical modelings in the literature that model or disregard the temporal variations of the coronary arteries on the hemodynamic parameters are discussed. The results in the literature show that neglecting the effects of temporal geometric variations is expected to result in about 5% deviation of the time-averaged pressure drop and wall shear stress values and also about 20% deviation of the temporal variations of hemodynamic parameters, such as time-dependent wall shear stress and oscillatory shear index. This review study can be considered as a guide for future studies to outline the conditions in which temporal variations of the coronary arteries can be neglected while providing a reliable estimation of hemodynamic parameters.
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Affiliation(s)
- Navid Freidoonimehr
- School of Mechanical Engineering, University of Adelaide, Adelaide, South Australia 5005, Australia
| | - Rey Chin
- School of Mechanical Engineering, University of Adelaide, Adelaide, South Australia 5005, Australia
| | - Anthony Zander
- School of Mechanical Engineering, University of Adelaide, Adelaide, South Australia 5005, Australia
| | - Maziar Arjomandi
- School of Mechanical Engineering, University of Adelaide, Adelaide, South Australia 5005, Australia
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