3D personalized left ventricular modeling revealed significantly higher dyssynchrony in AMI patients compared to healthy subjects (15.0% vs. 7.5%, P < 0.01).
Observational (n=44)
Does a 3D personalized LV model and thickening assessment framework accurately assess regional wall thickening dysfunction and dyssynchrony compared to clinical evaluation in AMI patients?
A novel 3D personalized LV modeling framework using MRI can accurately assess regional wall thickening dysfunction and dyssynchrony, correlating strongly with infarct severity in AMI patients.
Absolute Event Rate: 15% vs 7.5%
p-value: p=<0.01
BACKGROUND: Existing clinical diagnostic and assessment methods could be improved to facilitate early detection and treatment of cardiac dysfunction associated with acute myocardial infarction (AMI) to reduce morbidity and mortality. PURPOSE: To develop 3D personalized left ventricular (LV) models and thickening assessment framework for assessing regional wall thickening dysfunction and dyssynchrony in AMI patients. STUDY TYPE: Retrospective study, diagnostic accuracy. SUBJECTS: Forty-four subjects consisting of 15 healthy subjects and 29 AMI patients. FIELD STRENGTH/SEQUENCE: 1.5T/steady-state free precession cine MRI scans; LGE MRI scans. ASSESSMENT: Quantitative thickening measurements across all cardiac phases were correlated and validated against clinical evaluation of infarct transmurality by an experienced cardiac radiologist based on the American Heart Association (AHA) 17-segment model. STATISTICAL TEST: Nonparametric 2-k related sample-based Kruskal-Wallis test; Mann-Whitney U-test; Pearson's correlation coefficient. RESULTS: Healthy LV wall segments undergo significant wall thickening (P 50% transmurality) underwent remarkable wall thinning during contraction (thickening index TI = 1.46 ± 0.26 mm) as opposed to healthy myocardium (TI = 4.01 ± 1.04 mm). For AMI patients, LV that showed signs of thinning were found to be associated with a significantly higher percentage of dyssynchrony as compared with healthy subjects (dyssynchrony index DI = 15.0 ± 5.0% vs. 7.5 ± 2.0%, P < 0.01). Also, a strong correlation was found between our TI and left ventricular ejection fraction (LVEF) (r = 0.892, P < 0.01), and moderate correlation between DI and LVEF (r = 0.494, P < 0.01). DATA CONCLUSION: The extracted regional wall thickening and DIs are shown to be strongly correlated with infarct severity, therefore suggestive of possible practical clinical utility. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:1006-1019.
Khalid et al. (2018) conducted an observational in Acute myocardial infarction (AMI) (n=44). 3D personalized left ventricular models and thickening assessment framework vs. Healthy subjects was evaluated on Dyssynchrony index (DI) (p=<0.01). 3D personalized left ventricular modeling revealed significantly higher dyssynchrony in AMI patients compared to healthy subjects (15.0% vs. 7.5%, P < 0.01).