Exploration of the efficacy of radiomics applied to left ventricular tomograms obtained from D-SPECT MPI for the auxiliary diagnosis of myocardial ischemia in CAD

Abstract Purpose: To explore the feasibility and efficacy of radiomics with left ventricular tomograms obtained from D-SPECT myocardial perfusion imaging (MPI) for auxiliary diagnosis of myocardial ischemia in coronary artery disease (CAD).Methods: The images of 103 patients with CAD myocardial ischemia between September 2020 and April 2021 were retrospectively selected. After information desensitization processing, format conversion, annotation using the Labelme tool on an open-source platform, lesion classification, and establishment of a database, the images were cropped for analysis. The ResNet18 model was used to automate two steps (classification and segmentation) with five randomization, training and validation steps. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value, Youden’s index, agreement rate, and kappa value were calculated as evaluation indexes of the classification results for each training-validation step; then, receiver operating characteristics (ROC) curves were drawn, and the areas under the curve (AUCs) were calculated. The Dice coefficient, intersection over union, and Hausdorff distance were calculated as evaluation indexes of the segmentation results for each training-validation step; then, the predicted images were exported.Results: Under the existing conditions, the radiomics model can distinguish myocardial ischemia quite accurately, with AUCs all exceeding 0.95, and predict the areas of myocardial ischemia quite accurately; all evaluated indexes were close to those of the gold standard.Conclusion: Radiomics can be feasibly applied to left ventricular tomograms obtained from D-SPECT MPI for auxiliary diagnosis, with quite good results. Patients may benefit from this approach as technology evolves and associated software is developed.

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Vergleich von Belastungs- EKG und Radionuklid- Ventrikulographie bezüglich des Nachweises einer Myokardischämie bei isolierten Stenosen des Ramus interventricularis anterior

Nuklearmedizin ◽

10.1055/s-0038-1628908 ◽

1988 ◽

Vol 27 (02) ◽

pp. 57-62

Author(s):

R. Standke ◽

R. P. Baum ◽

S. Tezak ◽

D. Mildenberger ◽

F. D. Maul ◽

...

Keyword(s):

Heart Disease ◽

Left Ventricular Ejection Fraction ◽

Myocardial Ischemia ◽

Ejection Fraction ◽

Anterior Wall ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Global Ejection Fraction ◽

Ventricular Ejection Fraction ◽

Exercise Ecg

21 patients with LAD-stenoses of at least 70% and 21 patients with LAD- stenoses and additional intramural anterior wall infarctions were studied. 20 patients without heart disease or after successful transluminal coronary angioplasty and 18 patients with intramural anterior wall infarction after successful transluminal dilatation of the LAD (remaining stenosis maximal 30%) served as controls. The normal range of global and regional left ventricular ejection fraction response to exercise was defined based on the data of 25 further patients without relevant coronary heart disease. Thus, a decrease in global ejection fraction and regional wall motion abnormalities were judged pathological. All patients were comparable with respect to age, ejection fraction at rest and work load. Myocardial ischemia could be detected by the exercise ECG in 81 % of all patients without infarction and in 71 % of patients with infarction. The corresponding values for global left ventricular ejection fraction were 76% and 81 %, respectively, and for regional ejection fraction 95% in both groups. No false-positive exercise ECGs were observed in the healthy controls and 2 (11 %) in the corresponding group with intramural infarction. The global ejection fraction was pathological in 1 (5%) healthy subject without infarction and in 3 (17%) corresponding patients with infarction. Sectorial analysis revealed 5 and 22%, respectively. Our findings suggest that the exercise ECG has a limited sensitivity to detect myocardial ischemia in patients with isolated LAD-stenoses and intramural myocardial infarction. Radionuclide ventriculography yields pathological values more often; however, false-positive results also occur more frequently.

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Association of Carotid Atherosclerosis With Electrocardiographic Myocardial Ischemia and Left Ventricular Hypertrophy

Hypertension ◽

10.1161/01.hyp.28.1.3 ◽

1996 ◽

Vol 28 (1) ◽

pp. 3-7 ◽

Cited By ~ 15

Author(s):

Peter M. Okin ◽

Mary J. Roman ◽

Richard B. Devereux ◽

Paul Kligfield

Keyword(s):

Myocardial Ischemia ◽

Left Ventricular Hypertrophy ◽

Ventricular Hypertrophy ◽

Carotid Atherosclerosis ◽

Left Ventricular

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Intraventricular synchronism assessment by gated-SPECT myocardial perfusion imaging in cardiac resynchronization therapy. Does cardiomyopathy type influence results?

EJNMMI Research ◽

10.1186/s13550-020-00703-4 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Amalia Peix ◽

Kenia Padrón ◽

Lázaro O. Cabrera ◽

Osmín Castañeda ◽

Danet Milán ◽

...

Keyword(s):

Quality Of Life ◽

Myocardial Perfusion Imaging ◽

Gated Spect ◽

Left Ventricular ◽

Cardiac Resynchronization ◽

Spect Myocardial Perfusion Imaging ◽

Resynchronization Therapy ◽

Spect Mpi ◽

Spect Myocardial Perfusion

Abstract Purpose To analyze the evolution post-cardiac resynchronization therapy (CRT) in left ventricular non-compaction (LVNC) cardiomyopathy (CM) patients compared to other types of CM, according to clinical and functional variables, by using gated-SPECT myocardial perfusion imaging (MPI). Methods Ninety-three patients (60 ± 11 years, 28% women) referred for pre-CRT assessment were studied and divided into three groups: 1 (non-ischemic CM with LVNC, 11 patients), 2 (ischemic CM, 28 patients), and 3 (non-ischemic CM, 53 patients). All were studied by a 99mTc-MIBI gated-SPECT MPI at rest pre-CRT implantation and 6 ± 1 months after, including intraventricular dyssynchrony assessment by phase analysis. Quality of life was measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Results No differences in sex, atherosclerotic risk factors other than smoking habit, and MLHFQ results were found among groups. LVNC CM patients were younger, with greater QRS width and lower left ventricular ejection fraction (LVEF) at baseline, but the differences were not significant. No significant differences were found at baseline regarding ventricular function, although end-systolic volume was slightly higher in LVNC CM patients. Mean SRS was significantly higher (p < 0.0001) in ischemic patients (14.9) versus non-ischemic ones (8.7 in group 1 and 9 in group 2). At baseline, LVNC CM patients were significantly more dyssynchronous: Their phase standard deviation (PSD) was higher (89.5° ± 14.2°) versus groups 2 (65.2° ± 23.3°) and 3 (69.7° ± 21.7°), p = 0.007. Although the quality of life significantly improved in all groups, non-ischemic patients (with or without LVNC) showed a higher LVEF increase and volumes reduction at 6 months post-CRT. Dyssynchrony reduced post-CRT in all groups. Nevertheless, those more dyssynchronous at baseline (LVNC CM) exhibited the most significant intraventricular synchronism improvement: PSD was reduced from 89.5° ± 14.2° at baseline to 63.7° ± 20.5° post-CRT (p = 0.028). Six months post-CRT, 89% of patients were responders: 11 (100%) of those with LVNC CM, 25 (86%) of those with ischemic CM, and 47 (89%) of patients with non-ischemic CM. No patient with LVNC CM had adverse events during the follow-up. Conclusion CRT contributes to a marked improvement in non-ischemic CM patients with non-compaction myocardium. Phase analysis in gated-SPECT MPI is a valuable tool to assess the response to CRT.

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MicroRNA-330-5p inhibits NLRP3 inflammasome-mediated myocardial ischemia-reperfusion injury by targeting TIM3

European Heart Journal ◽

10.1093/ehjci/ehaa946.3648 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

W Zuo ◽

R Tian ◽

Q Chen ◽

L Wang ◽

Q Gu ◽

...

Keyword(s):

Myocardial Ischemia ◽

Reperfusion Injury ◽

Nlrp3 Inflammasome ◽

Ischemia Reperfusion Injury ◽

Infarct Volume ◽

Ischemia Reperfusion ◽

Left Ventricular ◽

Myocardial Ischemia Reperfusion Injury ◽

Myocardial Ischemia Reperfusion

Abstract Background Myocardial ischemia-reperfusion injury (MIRI) is one of the leading causes of human death. Nod-like receptor protein-3 (NLRP3) inflammasome signaling pathway involved in the pathogenesis of MIRI. However, the upstream regulating mechanisms of NLRP3 at molecular level remains unknown. Purpose This study investigated the role of microRNA330-5p (miR-330-5p) in NLRP3 inflammasome-mediated MIRI and the associated mechanism. Methods Mice underwent 45 min occlusion of the left anterior descending coronary artery followed by different times of reperfusion. Myocardial miR-330-5p expression was examined by quantitative polymerase chain reaction (PCR), and miR-330-5p antagomir and agomir were used to regulate miR-330-5p expression. To evaluate the role of miR-330-5p in MIRI, Evans Blue (EB)/2, 3, 5-triphenyltetrazolium chloride (TTC) staining, echocardiography, and immunoblotting were used to assess infarct volume, cardiac function, and NLRP3 inflammasome activation, respectively. Further, in vitro myocardial ischemia-reperfusion model was established in cardiomyocytes (H9C2 cell line). A luciferase binding assay was used to examine whether miR-330-5p directly bound to T-cell immunoglobulin domain and mucin domain-containing molecule-3 (TIM3). Finally, the role of miR-330-5p/TIM3 axis in regulating apoptosis and NLRP3 inflammasome formation were evaluated using flow cytometry assay and immunofluorescence staining. Results Compared to the model group, inhibiting miR-330-5p significantly aggravated MIRI resulting in increased infarct volume (58.09±6.39% vs. 37.82±8.86%, P<0.01) and more severe cardiac dysfunction (left ventricular ejection fraction [LVEF] 12.77%±6.07% vs. 27.44%±4.47%, P<0.01; left ventricular end-diastolic volume [LVEDV] 147.18±25.82 vs. 101.31±33.20, P<0.05; left ventricular end-systolic volume [LVESV] 129.11±30.17 vs. 74.29±28.54, P<0.05). Moreover, inhibiting miR-330-5p significantly increased the levels of NLRP3 inflammasome related proteins including caspase-1 (0.80±0.083 vs. 0.60±0.062, P<0.05), interleukin (IL)-1β (0.87±0.053 vs. 0.79±0.083, P<0.05), IL-18 (0.52±0.063 vs. 0.49±0.098, P<0.05) and tissue necrosis factor (TNF)-α (1.47±0.17 vs. 1.03±0.11, P<0.05). Furthermore, TIM3 was confirmed as a potential target of miR-330-5p. As predicted, suppression of TIM3 by small interfering RNA (siRNA) ameliorated the anti-miR-330-5p-mediated apoptosis of cardiomyocytes and activation of NLRP3 inflammasome signaling pathway (Figure 1). Conclusion Overall, our study indicated that miR-330-5p/TIM3 axis involved in the regulating mechanism of NLRP3 inflammasome-mediated myocardial ischemia-reperfusion injury. Figure 1 Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): National Natural Science Foundation of China Grants

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Prognostic Value of Myocardial Ischemia and Viability in Patients With Chronic Left Ventricular Ischemic Dysfunction

Circulation ◽

10.1161/01.cir.100.2.141 ◽

1999 ◽

Vol 100 (2) ◽

pp. 141-148 ◽

Cited By ~ 110

Author(s):

Agnès Pasquet ◽

Annie Robert ◽

Anne-Marie D’Hondt ◽

Robert Dion ◽

Jacques A. Melin ◽

...

Keyword(s):

Myocardial Ischemia ◽

Prognostic Value ◽

Left Ventricular

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Left ventricular pumping function and contractility changes after myocardial ischemia evoked by coronary arterial embolization by microspheres in anesthetized rats

Bulletin of Experimental Biology and Medicine ◽

10.1007/bf00841767 ◽

1989 ◽

Vol 107 (5) ◽

pp. 626-629

Author(s):

S. F. Dugin ◽

E. A. Gorodetskaya ◽

O. S. Medvedev ◽

M. V. Roitshtein ◽

D. V. Borovikov

Keyword(s):

Myocardial Ischemia ◽

Arterial Embolization ◽

Left Ventricular ◽

Anesthetized Rats ◽

Pumping Function

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Cardiac Troponin T Concentrations, Reversible Myocardial Ischemia, and Indices of Left Ventricular Remodeling in Patients with Suspected Stable Angina Pectoris: a DOPPLER-CIP Substudy

Clinical Chemistry ◽

10.1373/clinchem.2018.288894 ◽

2018 ◽

Vol 64 (9) ◽

pp. 1370-1379 ◽

Cited By ~ 7

Author(s):

Peder L Myhre ◽

Torbjørn Omland ◽

Sebastian I Sarvari ◽

Heikki Ukkonen ◽

Frank Rademakers ◽

...

Keyword(s):

Myocardial Ischemia ◽

Wall Motion ◽

Troponin T ◽

Left Ventricular ◽

Reference Limit ◽

Lv Mass ◽

Lv Remodeling ◽

Perfusion Defects ◽

Stable Cad ◽

Upper Reference Limit

Abstract BACKGROUND Cardiac troponin T concentrations measured with high-sensitivity assays (hs-cTnT) provide important prognostic information for patients with stable coronary artery disease (CAD). However, whether hs-cTnT concentrations mainly reflect left ventricular (LV) remodeling or recurrent myocardial ischemia in this population is not known. METHODS We measured hs-cTnT concentrations in 619 subjects with suspected stable CAD in a prospectively designed multicenter study. We identified associations with indices of LV remodeling, as assessed by cardiac MRI and echocardiography, and evidence of myocardial ischemia diagnosed by single positron emission computed tomography. RESULTS Median hs-cTnT concentration was 7.8 ng/L (interquartile range, 4.8–11.6 ng/L), and 111 patients (18%) had hs-cTnT concentrations above the upper reference limit (>14 ng/L). Patients with hs-cTnT >14 ng/L had increased LV mass (144 ± 40 g vs 116 ± 34 g; P < 0.001) and volume (179 ± 80 mL vs 158 ± 44 mL; P = 0.006), lower LV ejection fraction (LVEF) (59 ± 14 vs 62 ± 11; P = 0.006) and global longitudinal strain (14.1 ± 3.4% vs 16.9 ± 3.2%; P < 0.001), and more reversible perfusion defects (P = 0.001) and reversible wall motion abnormalities (P = 0.008). Age (P = 0.009), estimated glomerular filtration rate (P = 0.01), LV mass (P = 0.003), LVEF (P = 0.03), and evidence of reversible myocardial ischemia (P = 0.004 for perfusion defects and P = 0.02 for LV wall motion) were all associated with increasing hs-cTnT concentrations in multivariate analysis. We found analogous results when using the revised US upper reference limit of 19 ng/L. CONCLUSIONS hs-cTnT concentrations reflect both LV mass and reversible myocardial ischemia in patients with suspected stable CAD.

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