Assessing heterogeneity on cardiovascular magnetic resonance imaging: a novel approach to diagnosis and risk stratification in cardiac diseases.

Cardiac disease affects the heart non-uniformly. Examples include focal septal or apical hypertrophy with reduced strain in hypertrophic cardiomyopathy, replacement fibrosis with akinesia in an infarct-related coronary artery territory, and a pattern of scarring in dilated cardiomyopathy. The detail...

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Publicado en:European Heart Journal - Cardiovascular Imaging Vol. 25; no. 4; pp. 437 - 446
Autores principales: Hesse, Kerrick, Khanji, Mohammed Y, Aung, Nay, Dabbagh, Ghaith Sharaf, Petersen, Steffen E, Chahal, C Anwar A
Formato: pictorial review tables/charts Journal Article
Publicado: Oxford University Press / USA Apr2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2024
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      pub: Oxford University Press / USA
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        10.1093/ehjci/jead285
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        atl: Assessing heterogeneity on cardiovascular magnetic resonance imaging: a novel approach to diagnosis and risk stratification in cardiac diseases.
      aug:
        au:
          Hesse, Kerrick
          Khanji, Mohammed Y
          Aung, Nay
          Dabbagh, Ghaith Sharaf
          Petersen, Steffen E
          Chahal, C Anwar A
        affil: Cardiology Department, James Cook University Hospital , Marton Road, Middlesbrough TS4 3BW , UK
      sug:
        subj:
          Cardiovascular Diseases Radiography
          Cardiovascular Risk Factors
          Cardiovascular Diseases Diagnosis
          Magnetic Resonance Imaging Methods
          Biological Markers
          Early Diagnosis
          Myocardium Radiography
          Diagnosis, Cardiovascular
          Cardiomyopathy, Hypertrophic
          Cardiovascular Diseases Prognosis
      ab: Cardiac disease affects the heart non-uniformly. Examples include focal septal or apical hypertrophy with reduced strain in hypertrophic cardiomyopathy, replacement fibrosis with akinesia in an infarct-related coronary artery territory, and a pattern of scarring in dilated cardiomyopathy. The detail and versatility of cardiovascular magnetic resonance (CMR) imaging mean it contains a wealth of information imperceptible to the naked eye and not captured by standard global measures. CMR-derived heterogeneity biomarkers could facilitate early diagnosis, better risk stratification, and a more comprehensive prediction of treatment response. Small cohort and case–control studies demonstrate the feasibility of proof-of-concept structural and functional heterogeneity measures. Detailed radiomic analyses of different CMR sequences using open-source software delineate unique voxel patterns as hallmarks of histopathological changes. Meanwhile, measures of dispersion applied to emerging CMR strain sequences describe variable longitudinal, circumferential, and radial function across the myocardium. Two of the most promising heterogeneity measures are the mean absolute deviation of regional standard deviations on native T1 and T2 and the standard deviation of time to maximum regional radial wall motion, termed the tissue synchronization index in a 16-segment left ventricle model. Real-world limitations include the non-standardization of CMR imaging protocols across different centres and the testing of large numbers of radiomic features in small, inadequately powered patient samples. We, therefore, propose a three-step roadmap to benchmark novel heterogeneity biomarkers, including defining normal reference ranges, statistical modelling against diagnosis and outcomes in large epidemiological studies, and finally, comprehensive internal and external validations.
      pubtype: Academic Journal
      doctype:
        pictorial
        review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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