Radiomics Analysis Derived From LGE-MRI Predict Sudden Cardiac Death in Participants With Hypertrophic Cardiomyopathy

Objectives: To identify significant radiomics features derived from late gadolinium enhancement (LGE) images in participants with hypertrophic cardiomyopathy (HCM) and assess their prognostic value in predicting sudden cardiac death (SCD) endpoint.Method: The 157 radiomic features of 379 sequential participants with HCM who underwent cardiovascular magnetic resonance imaging (MRI) were extracted. CoxNet (Least Absolute Shrinkage and Selection Operator (LASSO) and Elastic Net) and Random Forest models were applied to optimize feature selection for the SCD risk prediction and cross-validation was performed.Results: During a median follow-up of 29 months (interquartile range, 20–42 months), 27 participants with HCM experienced SCD events. Cox analysis revealed that two selected features, local binary patterns (LBP) (19) (hazard ratio (HR), 1.028, 95% CI: 1.032–1.134; P = 0.001) and Moment (1) (HR, 1.212, 95%CI: 1.032–1.423; P = 0.02) provided significant prognostic value to predict the SCD endpoints after adjustment for the clinical risk predictors and late gadolinium enhancement. Furthermore, the univariately significant risk predictor was improved by the addition of the selected radiomics features, LBP (19) and Moment (1), to predict SCD events (P < 0.05).Conclusion: The radiomics features of LBP (19) and Moment (1) extracted from LGE images, reflecting scar heterogeneity, have independent prognostic value in identifying high SCD risk patients with HCM.

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Late Gadolinium Enhancement–Dispersion Mapping

Circulation Cardiovascular Imaging ◽

10.1161/circimaging.120.010489 ◽

2020 ◽

Vol 13 (6) ◽

Author(s):

Giovanni Donato Aquaro ◽

Chrysanthos Grigoratos ◽

Antonio Bracco ◽

Alberto Proclemer ◽

Giancarlo Todiere ◽

...

Keyword(s):

Late Gadolinium Enhancement ◽

Hypertrophic Cardiomyopathy ◽

Sudden Cardiac Death ◽

Cardiac Death ◽

Average Score ◽

Cardiac Events ◽

Gadolinium Enhancement ◽

Net Reclassification Improvement ◽

Kaplan Meier ◽

Central Pixel

Background: Late gadolinium enhancement (LGE) is an important prognostic marker in hypertrophic cardiomyopathy and an extent >15% it is associated with high risk of sudden cardiac death. We proposed a novel method, the LGE-dispersion mapping, to assess heterogeneity of scar, and evaluated its prognostic role in patients with hypertrophic cardiomyopathy. Methods: One hundred eighty-three patients with hypertrophic cardiomyopathy and a low- or intermediate 5-year risk of sudden cardiac death underwent cardiac magnetic resonance imaging. A parametric map was generated from each LGE image. A score from 0 to 8 was assigned at every pixel of these maps, indicating the number of the surrounding pixels having different quality (nonenhancement, mild-enhancement, or hyperenhancement) from the central pixel. The Global Dispersion Score (GDS) was calculated as the average score of all the pixels of the images. Results: During a median follow-up time of 6 (25th–75th, 4–10) years, 22 patients had hard cardiac events (sudden cardiac death, appropriate implantable cardioverter-defibrillator therapy, resuscitated cardiac arrest, and sustained ventricular tachycardia). Kaplan-Meier analysis showed that patients with GDS>0.86 had worse prognosis than those with lower GDS ( P <0.0001). GDS>0.86 was the only independent predictor of cardiac events (hazard ratio, 9.9 [95% CI, 2.9–34.6], P =0.0003). When compared with LGE extent >15%, GDS improved the classification of risk in these patients (net reclassification improvement, 0.39 [95% CI, 0.11–0.72], P <0.019). Conclusions: LGE-dispersion mapping is a marker of scar heterogeneity and provides a better risk stratification than LGE presence and its extent in patients with hypertrophic cardiomyopathy and a low-intermediate 5-year risk of sudden cardiac death.

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Prognostic Role of Late Gadolinium Enhancement in Patients With Hypertrophic Cardiomyopathy and Low-to-Intermediate Sudden Cardiac Death Risk Score

The American Journal of Cardiology ◽

10.1016/j.amjcard.2019.07.023 ◽

2019 ◽

Vol 124 (8) ◽

pp. 1286-1292 ◽

Cited By ~ 8

Author(s):

Giancarlo Todiere ◽

Cinzia Nugara ◽

Giovanni Gentile ◽

Francesco Negri ◽

Francesco Bianco ◽

...

Keyword(s):

Late Gadolinium Enhancement ◽

Hypertrophic Cardiomyopathy ◽

Sudden Cardiac Death ◽

Risk Score ◽

Cardiac Death ◽

Prognostic Role ◽

Gadolinium Enhancement ◽

Death Risk ◽

Sudden Cardiac Death Risk

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Late gadolinium enhancement is common in patients with hypertrophic cardiomyopathy and no clinical risk factors for sudden cardiac death: A single center experience

Cardiology Journal ◽

10.5603/cj.a2013.0115 ◽

2014 ◽

Vol 21 (1) ◽

pp. 29-32 ◽

Cited By ~ 3

Author(s):

Kristopher S. Lyons ◽

Lana J. Dixon ◽

Nicola Johnston ◽

Rebecca Noad ◽

Andrew Hamilton ◽

...

Keyword(s):

Risk Factors ◽

Late Gadolinium Enhancement ◽

Hypertrophic Cardiomyopathy ◽

Sudden Cardiac Death ◽

Cardiac Death ◽

Clinical Risk Factors ◽

Single Center ◽

Gadolinium Enhancement ◽

Clinical Risk ◽

Single Center Experience

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The Potential of Late Gadolinium Enhancement to Serve as a Predictor of Ventricular Arrhythmias in Hypertrophic Cardio-myopathy Patients

The Open Hypertension Journal ◽

10.2174/1876526201608010001 ◽

2016 ◽

Vol 8 (1) ◽

pp. 1-11

Author(s):

Thomas D. Gossios ◽

Georgios K. Efthimiadis ◽

Theodoros D. Karamitsos ◽

Thomas Zegkos ◽

Vasilios G. Athyros ◽

...

Keyword(s):

Late Gadolinium Enhancement ◽

Hypertrophic Cardiomyopathy ◽

Sudden Cardiac Death ◽

Sudden Death ◽

Cardiac Death ◽

Large Scale ◽

Small Subset ◽

Gadolinium Enhancement ◽

Inherited Cardiomyopathy ◽

Increased Risk

Hypertrophic cardiomyopathy, the most common inherited cardiomyopathy is well known to be the leading cause of sudden cardiac death in young people. However, amongst the population of patients, a small subset bears increased risk of sudden cardiac death and would benefit from implantation of a defibrillator, currently recognized utilizing a series of established risk factors. This risk stratification model is hampered by low positive predictive value. Therefore, novel predictors of sudden death are sought. The advent of cardiac magnetic resonance and late gadolinium enhancement has allowed accurate quantification of regional fibrosis, a key element of hypertrophic cardiomyopathy, pathophysiologically linked to increased arrhythmogenicity. We sought to review currently available data on the utility of late gadolinium enhancement to serve as a novel predictor of arrhythmias and sudden death. In conclusion, significantly diverse methodological approaches and subsequent findings between available studies on the topic have hampered such use, highlighting the need for uniformly designed large scale, prospective studies in order to clarify which aspects of myocardial fibrosis could serve as predictors of arrhythmic events.

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