Department of Cardiology, Renji Hospital, School of Medicine Shanghai Jiaotong University, Shanghai, China.
Department of Radiology, Renji Hospital, School of Medicine Shanghai Jiaotong University, Shanghai, China.
J Magn Reson Imaging. 2023 Oct;58(4):1084-1097. doi: 10.1002/jmri.28580. Epub 2023 Jan 23.
Differentiating hypertrophic cardiomyopathy (HCM) from hypertensive heart disease (HHD) is challenging.
To identify differences between HCM and HHD on a patient basis using MRI.
Retrospective.
A total of 219 subjects, 148 in phase I (baseline data and algorithm development: 75 HCM, 33 HHD, and 40 controls) and 71 in phase II (algorithm validation: 56 HCM and 15 HHD).
FIELD STRENGTH/SEQUENCE: Contrast-enhanced inversion-prepared gradient echo and cine-balanced steady-state free precession sequences at 3.0 T.
MRI parameters assessed included left ventricular (LV) ejection fraction (LVEF), LV end systolic and end diastolic volumes (LVESV and LVEDV), mean maximum LV wall thickness (MLVWT), LV global longitudinal and circumferential strain (GRS, GLS, and GCS), and native T1. Parameters, which were significantly different between HCM and HHD in univariable analysis, were entered into a principal component analysis (PCA). The selected components were then introduced into a multivariable regression analysis to model an integrated algorithm (IntA) for screening the two disorders. IntA performance was assessed for patients with and without LGE in phase I (development) and phase II (validation).
Univariable regression, PCA, receiver operating curve (ROC) analysis. A P value <0.05 was considered statistically significant.
Derived IntA formulation included LVEF, LVESV, LVEDV, MLVWT, and GCS. In LGE-positive subjects in phase l, the cutoff point of IntA ≥81 indicated HCM (83% sensitivity and 91% specificity), with the area under the ROC curve (AUC) of 0.900. In LGE-negative subjects, a higher possibility of HCM was indicated by a cutoff point of IntA ≥84 (100% sensitivity and 82% specificity), with an AUC of 0.947. Validation of IntA in phase II resulted in an AUC of 0.846 in LGE-negative subjects and 0.857 in LGE-positive subjects.
A per-patient-based IntA algorithm for differentiating HCM and HHD was generated from MRI data and incorporated FT, LGE and morphologic parameters.
Stage 2.
区分肥厚型心肌病（HCM）和高血压性心脏病（HHD）具有挑战性。
使用 MRI 从患者角度识别 HCM 和 HHD 之间的差异。
回顾性。
共 219 名受试者，第 I 阶段（基线数据和算法开发：75 名 HCM、33 名 HHD 和 40 名对照）共 148 名，第 II 阶段（算法验证：56 名 HCM 和 15 名 HHD）共 71 名。
磁场强度/序列：3.0T 下的对比增强反转预脉冲梯度回波和电影平衡稳态自由进动序列。
评估的 MRI 参数包括左心室（LV）射血分数（LVEF）、LV 收缩末期和舒张末期容积（LVESV 和 LVEDV）、平均最大 LV 壁厚度（MLVWT）、LV 整体纵向和圆周应变（GRS、GLS 和 GCS）以及原生 T1。单变量分析中 HCM 和 HHD 之间有显著差异的参数被纳入主成分分析（PCA）。然后，将选定的组件引入多变量回归分析，以建立用于筛查两种疾病的综合算法（IntA）。在第 I 阶段（开发）和第 II 阶段（验证）中，评估了 IntA 在有和无 LGE 的患者中的性能。
单变量回归、PCA、接收者操作曲线（ROC）分析。P 值<0.05 被认为具有统计学意义。
推导的 IntA 公式包括 LVEF、LVESV、LVEDV、MLVWT 和 GCS。在第 I 阶段的 LGE 阳性受试者中，IntA≥81 的截断值提示 HCM（83%的敏感性和 91%的特异性），ROC 曲线下面积（AUC）为 0.900。在 LGE 阴性受试者中，IntA≥84 的截断值提示更有可能患有 HCM（100%的敏感性和 82%的特异性），AUC 为 0.947。在第 II 阶段验证 IntA 时，LGE 阴性受试者的 AUC 为 0.846，LGE 阳性受试者的 AUC 为 0.857。
从 MRI 数据中生成了一种基于每个患者的 IntA 算法，用于区分 HCM 和 HHD，并纳入了 FT、LGE 和形态学参数。
3。
第 2 阶段。
