背景:致心律失常性心肌病(ACM)的特征是进行性心肌纤维脂肪浸润并伴有小梁紊乱。传统上,二维(2D)代替3D分形维数(FD)分析已用于评估小梁混乱。然而,通过3DFD测量评估骨小梁疾病的预后价值尚不清楚.
目的:使用基于心脏MR电影图像的3DFD分析来研究ACM患者右心室小梁复杂性的预后价值。
方法:回顾性。
方法:85例ACM患者(平均年龄:45±17岁,52男)。
■3.0T/电影影像,T2-短tau反转恢复(T2-STIR),和晚期钆增强(LGE)。
结果:使用电影图像,获得右心室(RV)体积和功能参数。采用三维分形分析法对RV骨小梁复杂度进行测量,计算3D-FD。建立Cox和logistic回归模型,评价3D-FD对主要不良心脏事件(MACE)的预后价值。
方法:Cox回归和logistic回归分析3D-FD的预后价值。C指数,时间依赖性受试者工作特征(ROC)曲线和ROC曲线下面积(AUC)来评估3D-FD的增量值。观察者间变异性的组内相关系数。P<0.05表示有统计学意义。
结果:在60个月的随访期间(四分位距:48-67个月)记录了26次MACE。RV3D-FD在有MACE(2.67,四分位距:2.51〜2.81)和无(2.52,四分位距:2.40〜2.67)的ACM患者之间存在显着差异,并且是MACE的显着独立危险因素(风险比,1.02;95%置信区间:1.01,1.04)。此外,将3D-FD添加到RV全局纵向应变后,预后模型适应度显着提高,LV参与,和5年风险评分分别。
结论:通过3DFD分析评估的心肌小梁复杂性与MACE相关,并提供超越常规ACM危险因素的增量预后价值。
方法:4技术效果:第一阶段。
BACKGROUND: Arrhythmogenic cardiomyopathy (ACM) is characterized by progressive myocardial fibro-fatty infiltration accompanied by trabecular disarray. Traditionally, two-dimensional (2D) instead of 3D fractal dimension (FD) analysis has been used to evaluate trabecular disarray. However, the prognostic value of trabecular disorder assessed by 3D FD measurement remains unclear.
OBJECTIVE: To investigate the prognostic value of right ventricular trabecular complexity in ACM patients using 3D FD analysis based on cardiac MR cine images.
METHODS: Retrospective.
METHODS: 85 ACM patients (mean age: 45 ± 17 years, 52 male).
UNASSIGNED: 3.0T/cine imaging, T2-short tau inversion recovery (T2-STIR), and late gadolinium enhancement (LGE).
RESULTS: Using cine images, RV (right ventricular) volumetric and functional parameters were obtained. RV trabecular complexity was measured with 3D fractal analysis by box-counting method to calculate 3D-FD. Cox and logistic regression models were established to evaluate the prognostic value of 3D-FD for major adverse cardiac events (MACE).
METHODS: Cox regression and logistic regression to explore the prognostic value of 3D-FD. C-index, time-dependent receiver operating characteristic (ROC) curves and area under the ROC curve (AUC) to evaluate the incremental value of 3D-FD. Intraclass correlation coefficient for interobserver variability. P < 0.05 indicated statistical significance.
RESULTS: 26 MACE were recorded during the 60 month follow-up (interquartile range: 48-67 months). RV 3D-FD significantly differed between ACM patients with MACE (2.67, interquartile range: 2.51 ~ 2.81) and without (2.52, interquartile range: 2.40 ~ 2.67) and was a significant independent risk factor for MACE (hazard ratio, 1.02; 95% confidence interval: 1.01, 1.04). In addition, prognostic model fitness was significantly improved after adding 3D-FD to RV global longitudinal strain, LV involvement, and 5-year risk score separately.
CONCLUSIONS: The myocardial trabecular complexity assessed through 3D FD analysis was found associated with MACE and provided incremental prognostic value beyond conventional ACM risk factors.
METHODS: 4 TECHNICAL EFFICACY: Stage 1.