Value of CMR radiomics combined with clinical factors in predicting hypertrophic cardiomyopathy complicated by ventricular arrhythmias

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• Clinical Article •

LÜ Jing ZHU Yongqi ZHU Yanfang HE Ying HU Qian SHAO Jiujie WANG Yilin WANG Pei LIU Yun ZHU Li

Cite this article as: LÜ J, ZHU Y Q, ZHU Y F, et al. Value of CMR radiomics combined with clinical factors in predicting hypertrophic cardiomyopathy complicated by ventricular arrhythmias[J]. Chin J Magn Reson Imaging, 2024, 15(4): 63-71, 87. DOI:10.12015/issn.1674-8034.2024.04.011.

Abstract

[Abstract] Objective To explore the value of radiomics features of myocardium in different regions based on cardiac magnetic resonance (CMR) and related clinical factors in predicting hypertrophic cardiomyopathy complicated by ventricular arrhythmias.Materials and Methods The CMR images and clinical data of 122 patients diagnosed with HCM from January 1, 2018 to May 31, 2023 were retrospectively collected and analyzed. According to the results of 24-hour dynamic electrocardiogram (24 h DCG), the patients were divided into a VAs combined group (40 cases) and a VAs uncombined group (82 cases). All subjects were divided into a training set and a test set according to a ratio of 7∶3. The training set was used to build the model, and the test set was used to evaluate the model efficacy. The left ventricular short axis unenhanced bright blood cine sequence from mitral valve level to apex was selected. On the basis of end-diastolic wall thickness , the myocardium of HCM patients was divided into hypertrophic regions and non-hypertrophic regions. At the end of ventricular diastole in all layers of left ventricular short axis myocardium, the delineation of areas of interest and the extraction of radiomics features of the whole ventricular wall myocardium, the myocardium in hypertrophic regions and non-hypertrophic regions were performed. Mann-Whitney U test, recursive feature elimination method and least absolute shrinkage and selection operator were used to screen the radiomics features, construct the radiomics model, establish the radiomics label and calculate the radiomics score. The clinical risk factors were screened by logistic regression analysis to establish the clinical factor model, and combined model which based on clinical risk factors and radiomcs features was constructed. Accuracy, sensitivity, specificity, positive predictive value, negative predictive value, area under the curve (AUC) and DeLong test were used to evaluate and compare the predictive power of models. The combined model was visualized by using a nomogram, and the fitting degree of the combined model was evaluated by Hosmer-Lemeshow test (H-L test) and calibration curve. The clinical practicability of the combined model was observed through decision curve analysis.Results In the training set, the AUC values of the combined model of the left ventricular non-hypertrophic region (AUC=0.89), combined model of the left ventricular hypertrophic region (AUC=0.98), combined model of the left ventricular whole myocardium (AUC=0.98) were higher than those of the radiomics model of left ventricular non-hypertrophic regions myocardium (AUC=0.74) and the radiomics model of left ventricular hypertrophic regions myocardium (AUC=0.85) and the radiomics model of left ventricular whole myocardium (AUC=0.86) (P<0.05) were higher than clinical factor model (AUC value=0.81) (P<0.05). The AUC value of the combined model of left ventricular non-hypertrophic regions myocardium (AUC=0.89) was lower than that of the combined model of left ventricular hypertrophic regions myocardium (AUC=0.98) and the combined model of left ventricular whole myocardium (AUC=0.98) (P<0.05). There was no significant difference in the AUC value between the combined model of left ventricular hypertrophy and the combined model of left ventricular whole myocardium (P>0.05). In the test set, the AUC value of the radiomics model of left ventricular non-hypertrophic regions myocardium (AUC=0.75) was lower than that of the combined model of left ventricular whole myocardium (AUC=0.93) and the combined model of left ventricular hypertrophic regions myocardium (AUC=0.95) (P<0.05). The AUC of the combined model of left ventricular hypertrophic regions myocardium (AUC=0.95) was higher than that of the combined model of left ventricular non-hypertrophy regions myocardium (AUC=0.80) (P<0.05).Conclusions The model based on the radiomics features of myocardium in different regions of CMR and related clinical factors has important value in predicting the risk of HCM patients complicated by VAs.

[Keywords] hypertrophic cardiomyopathy；ventricular arrhythmias；prediction model；cardiac magnetic resonance；radiomics；magnetic resonance imaging

Contributor Information

LÜ Jing¹ ZHU Yongqi² ZHU Yanfang³ HE Ying¹ HU Qian¹ SHAO Jiujie¹ WANG Yilin¹ WANG Pei⁴ LIU Yun⁴ ZHU Li^4*

¹ First School of Clinical Medicine, Ningxia Medical University, Yinchuan 750004, China

² Medical Imaging Center, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, China

³ Department of Radiology, Yinchuan Maternal and Child Health Care Hospital, Yinchuan 750299, China

⁴ Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750004, China

Corresponding author: ZHU L, E-mail: zhuli72@163.com

Conflicts of interest None.

Publication Information

Received 2023-10-23

Accepted 2024-03-22

DOI: 10.12015/issn.1674-8034.2024.04.011

Text

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