Key result
Atlas-based shape and motion z-scores outperform standard metrics in discriminating AF, HF, and ischemic disease.
Why the study?
Standard cardiac functional metrics ignore extensive systolic shape change information available from CMR examinations.
Do automated multidimensional shape and motion scores from CMR improve discrimination of prevalent cardiovascular disease compared to standard functional metrics?
Cross-Sectional (n=38,858)
Yes
Do automated multidimensional shape and motion scores from CMR improve discrimination of prevalent cardiovascular disease compared to standard functional metrics?
Answers are grounded in this paper and cite their sources.
Automated 3D biventricular shape and motion scores from CMR capture more discriminative information regarding prevalent cardiovascular disease than standard functional metrics like ejection fraction and strain.
BACKGROUND: Cardiac functional metrics such as ejection fraction, strain, and valve excursion are important diagnostic and prognostic measures of cardiac disease. However, they ignore a large amount of systolic shape change information available from modern cardiovascular magnetic resonance (CMR) examinations. We aimed to automatically quantify multidimensional shape and motion scores from CMR, investigate covariates, and test their discrimination of disease in the UK Biobank compared against standard functional metrics. METHODS: An automated analysis pipeline was used to obtain quality-controlled three-dimensional left and right ventricular shape models in 38,858 UK Biobank participants, 5149 of whom had one or more diagnoses of cardiovascular or cardiometabolic disease. Principal component analysis was used to obtain a statistical shape atlas and quantify each participant's left and right ventricular shape at both end-diastole and end-systole simultaneously. Systolic strain was obtained from arc length changes computed from the shape model, and mitral/tricuspid annular plane systolic excursion (MAPSE/TAPSE) was computed from the displacement of the valves. Discrimination for prevalent disease was quantified using linear discriminant analysis area under the receiver operating characteristic curve. RESULTS: The first 25 principal component scores captured >90% of the total shape variance. Significantly stronger discrimination for atrial fibrillation, heart failure, diabetes, ischemic disease, and conduction disorders (p<0.001 for each) was obtained using shape scores compared with volumes, ejection fractions, strains, MAPSE, and TAPSE. CONCLUSION: Automatically derived shape and motion z-scores capture more discriminative information on disease effects than standard metrics, including volumes, ejection fraction, strain and valve excursions.
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Burns et al. (2025) conducted a cross-sectional in Cardiovascular or cardiometabolic disease (n=38,858). Atlas-based shape and motion z-scores (Principal Component Analysis) vs. Standard functional metrics (volumes, ejection fraction, strain, MAPSE, TAPSE) was evaluated on Discrimination for prevalent disease (area under the receiver operating characteristic curve) (p=<0.001). Atlas-based shape and motion z-scores provided significantly stronger discrimination for atrial fibrillation, heart failure, diabetes, ischemic disease, and conduction disorders than standard metrics.
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