Wang Lujing, Peng Liang, Zhao Xiaoying, Ma Yunting, Jin Fuwei, Zhao Xinxiang
Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, 374(th) Dianmian Road, Wuhua District, Kunming, Yunnan, 650101, China.
School of Computer Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.
Acad Radiol. 2023 Feb;30(2):239-247. doi: 10.1016/j.acra.2022.03.021. Epub 2022 Apr 25.
To explore the prognostic value of entropy derived from late gadolinium enhancement images on cardiac magnetic resonance (CMR) for major adverse cardiac events (MACE) in post-myocardial infarction (MI) patients.
Participants with MI underwent 3.0T CMR were retrospectively enrolled. CMR parameters, including the entropy of infarct core (IC), peri-infarct border zone (BZ), and infarct core and peri-infarct border zone (IBZ) were analyzed. Patients were divided into the No-MACE group and the MACE group according to the absence or presence of MACE during the follow-up period.
Eighty-four patients were included, among whom 51 patients without MACE and 33 patients with MACE. The MACE group showed higher IC mass, IBZ mass, IC entropy, BZ entropy, IBZ entropy, and LV entropy and lower LVEF than those of the NO-MACE group. LVEF, BZ entropy, and IBZ entropy were independent predictors of MACE (p < 0.05). Receiver operating characteristic curve revealed that the predictive values of BZ entropy with AUC of 0.860, IBZ entropy with AUC of 0.930, the combined model of LVEF and BZ entropy with AUC of 0.923, and the combined model of LVEF and IBZ entropy with AUC of 0.954 were higher than that of LVEF with AUC of 0.797. Delong test illustrated there was no significant difference in AUC among the three models with AUC > 0.900 (p > 0.05).
BZ entropy and IBZ entropy were noninvasive parameters for better risk stratification of post-MI patients. MI Patients with MACE showed higher BZ entropy and IBZ entropy than patients without MACE.
探讨心肌梗死（MI）后患者心脏磁共振成像（CMR）延迟钆增强图像得出的熵对主要不良心脏事件（MACE）的预后价值。
回顾性纳入接受3.0T CMR检查的MI患者。分析CMR参数，包括梗死核心（IC）、梗死周边边界区（BZ）以及梗死核心与梗死周边边界区（IBZ）的熵。根据随访期间是否发生MACE将患者分为无MACE组和MACE组。
共纳入84例患者，其中51例无MACE，33例发生MACE。MACE组的IC质量、IBZ质量、IC熵、BZ熵、IBZ熵和左心室（LV）熵高于无MACE组，左心室射血分数（LVEF）低于无MACE组。LVEF、BZ熵和IBZ熵是MACE的独立预测因素（p<0.05）。受试者工作特征曲线显示，BZ熵的预测价值（曲线下面积[AUC]为0.860）、IBZ熵的预测价值（AUC为0.930）、LVEF与BZ熵的联合模型的预测价值（AUC为0.923）以及LVEF与IBZ熵的联合模型的预测价值（AUC为0.954）均高于LVEF的预测价值（AUC为0.797）。德龙检验表明，AUC>0.900的三个模型的AUC无显著差异（p>0.05）。
BZ熵和IBZ熵是对MI后患者进行更好风险分层的无创参数。发生MACE的MI患者的BZ熵和IBZ熵高于未发生MACE的患者。
