scholarly journals Cardiac Magnetic Resonance Radiomics Reveal Differential Impact of Sex, Age, and Vascular Risk Factors on Cardiac Structure and Myocardial Tissue

2021 ◽  
Vol 8 ◽  
Author(s):  
Zahra Raisi-Estabragh ◽  
Akshay Jaggi ◽  
Polyxeni Gkontra ◽  
Celeste McCracken ◽  
Nay Aung ◽  
...  

Background: Cardiovascular magnetic resonance (CMR) radiomics analysis provides multiple quantifiers of ventricular shape and myocardial texture, which may be used for detailed cardiovascular phenotyping.Objectives: We studied variation in CMR radiomics phenotypes by age and sex in healthy UK Biobank participants. Then, we examined independent associations of classical vascular risk factors (VRFs: smoking, diabetes, hypertension, high cholesterol) with CMR radiomics features, considering potential sex and age differential relationships.Design: Image acquisition was with 1.5 Tesla scanners (MAGNETOM Aera, Siemens). Three regions of interest were segmented from short axis stack images using an automated pipeline: right ventricle, left ventricle, myocardium. We extracted 237 radiomics features from each study using Pyradiomics. In a healthy subset of participants (n = 14,902) without cardiovascular disease or VRFs, we estimated independent associations of age and sex with each radiomics feature using linear regression models adjusted for body size. We then created a sample comprising individuals with at least one VRF matched to an equal number of healthy participants (n = 27,400). We linearly modelled each radiomics feature against age, sex, body size, and all the VRFs. Bonferroni adjustment for multiple testing was applied to all p-values. To aid interpretation, we organised the results into six feature clusters.Results: Amongst the healthy subset, men had larger ventricles with dimmer and less texturally complex myocardium than women. Increasing age was associated with smaller ventricles and greater variation in myocardial intensities. Broadly, all the VRFs were associated with dimmer, less varied signal intensities, greater uniformity of local intensity levels, and greater relative presence of low signal intensity areas within the myocardium. Diabetes and high cholesterol were also associated with smaller ventricular size, this association was of greater magnitude in men than women. The pattern of alteration of radiomics features with the VRFs was broadly consistent in men and women. However, the associations between intensity based radiomics features with both diabetes and hypertension were more prominent in women than men.Conclusions: We demonstrate novel independent associations of sex, age, and major VRFs with CMR radiomics phenotypes. Further studies into the nature and clinical significance of these phenotypes are needed.

2020 ◽  
Vol 9 (16) ◽  
Author(s):  
Anna Laveskog ◽  
Rui Wang ◽  
Davide L. Vetrano ◽  
Lena Bronge ◽  
Lars‐Olof Wahlund ◽  
...  

Background Evidence suggests that enlarged perivascular spaces (PVSs) may represent a marker for cerebral small‐vessel disease. We investigated whether vascular risk factors are correlated with visible PVS in older adults. Methods and Results This population‐based study included 530 participants (age ≥60 years) who were free from dementia and functional dependence, derived from the Swedish National study on Aging and Care in Kungsholmen (2001–2003). We collected data on demographics, vascular risk factors, and health conditions through interviews, clinical examinations, laboratory tests, and patient registers. Cerebral PVSs and white matter hyperintensities on magnetic resonance images were visually assessed with semiquantitative visual rating scales. Data were analyzed using the general linear regression models. After controlling for demographics and cardiovascular disease, very high blood pressure (≥160/100 mm Hg) was significantly associated with global PVS score (β‐coefficient, 1.30; 95% CI, 0.06–2.53) and orthostatic hypotension was associated with PVS score in the basal ganglia (β‐coefficient 0.37; 0.03–0.70), but the associations became non‐significant when adjusting for white matter hyperintensity load. Orthostatic hypotension was significantly associated with global and lobar PVS scores in carriers but not in noncarriers of the APOE ε4 allele. Global or regional PVS score was not significantly associated with other traditional vascular risk factors such as smoking, diabetes mellitus, physical inactivity, and overweight or obesity. Conclusions This study provides limited evidence supporting a correlation of magnetic resonance imaging–visible PVS with traditional vascular risk factors in older adults. The association of orthostatic hypotension with lobar PVS among APOE ε4 carriers suggests that lobar PVS may be a marker for amyloid‐associated small‐vessel disease.


2021 ◽  
pp. 238-241
Author(s):  
Nicholas L. Zalewski

A 51-year-old woman was seen for evaluation of transverse myelitis. Pertinent medical history included hypertension, hyperlipidemia, and 50 pack-years of cigarette smoking. Two months earlier, she was shopping and suddenly had excruciating pain in her upper back. Two hours later, severe weakness of both hands developed abruptly. Over the next 8 hours, severe paraparesis and urinary retention developed, with inability to lift legs against gravity, and she reported a T1 sensory level. Review of the outside magnetic resonance imaging noted key imaging findings, including initially normal magnetic resonance imaging within the first 12 hours of symptom presentation, and subsequent magnetic resonance imaging on day 3 showing anterior pencil-like hyperintensity on sagittal view and anterior U- or V-shaped pattern on axial view (termed U/V pattern), without associated gadolinium enhancement. Diffusion-weighted imaging was not obtained. Given the rapid, severe deficits with pain, spinal cord infarction was considered most likely, and the magnetic resonance imaging findings were typical. Magnetic resonance angiography of the neck with T1-fat-saturated views was obtained and did not show dissection. Laboratory evaluation showed a low-density lipoprotein value of 124 mg/dL and hemoglobin A1c of 6.2%. The patient was diagnosed with probable spontaneous spinal cord infarction on the basis of diagnostic criteria. The patient was counselled on smoking cessation, started on an aspirin and statin regimen, and followed up by a primary care provider for management of vascular risk factors. Residual neuropathic pain was treated with high doses of gabapentin. Importantly, unnecessary additional immunotherapy was avoided by establishing the correct diagnosis. Spontaneous spinal cord infarctions are an underrecognized cause of acute myelopathy. Spinal cord infarctions generally occur in older persons, with most cases associated with typical vascular risk factors, arterial dissection, and fibrocartilaginous embolism; historically, cases were often secondary to syphilis.


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Victor J Del Brutto ◽  
Chuanhui Dong ◽  
Digna E Cabral ◽  
Jose G Romano ◽  
Jose Gutierrez ◽  
...  

Background: Internal carotid artery (ICA) angle of origin is considered a contributor to atherogenesis because of its influence on hemodynamics. It is controversial if ICA angle variations are causal or consequential to carotid atherosclerosis or vascular risk factors. We aim to determine whether vascular risk factors underly ICA angle interindividual variations. Methods: The study included 1,111 stroke-free participants of the population-based Northern Manhattan Study (NOMAS) who underwent ICA angle estimation using B-mode carotid ultrasound (mean age 68.7±8.9 years; 41% were men, 60% Hispanic, 21% Black, and 18% White). Multivariable linear regression models were fit to assess the relationship of ICA angle to vascular risk factors. Results: ICA angle was significantly wider on the left compared to the right (26.6 ±15.5 degrees versus 18.6 ±12.9 degrees; p<0.001). In multivariate analyses, left ICA angle was correlated with age (B=0.07; p=0.03), female sex (B=0.09; p=0.004), Black race (B=0.11; p=0.02), and diastolic blood pressure (B=0.16; p<0.001), whereas right ICA angle was positively correlated with body mass index (B=0.07; p=0.04) and physical inactivity (B=0.08; p=0.02), and inversely correlated with low-density lipoprotein level (B=-0.1; p=0.004). Overall, these factors explained less than 5% of ICA angle variance (R 2 =0.0399 on the left; R 2 =0.0197 on the right). Conclusion: ICA angle variations are poorly explained by vascular risk factors at the population level. Our results suggest ICA angle is an independent feature that may predispose to atherogenesis.


2012 ◽  
Vol 8 (5) ◽  
pp. 417-425 ◽  
Author(s):  
Tom den Heijer ◽  
Fedde van der Lijn ◽  
Arfan Ikram ◽  
Peter J. Koudstaal ◽  
Aad van der Lugt ◽  
...  

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