Heart failure & cardiomyopathiesDiagnostic or prognostic study
Radiomics of Late Gadolinium Enhancement Reveals Prognostic Value of Myocardial Scar Heterogeneity in Hypertrophic Cardiomyopathy
- Prognostic cohort study
- multicentre (3 centres)
Authors' conclusion
Myocardial LGE radiomics are strongly associated with SCD risk in HCM and provide incremental risk stratification beyond current ESC or AHA/ACC risk models.
Study context
- Population
- Hypertrophic cardiomyopathy (HCM) patients with late gadolinium enhancement (LGE) CMR, 3 medical centres
- Participants
- 1,229 patients
- Comparison
- LGE radiomics, alone or combined, vs European Society of Cardiology (ESC) and American College of Cardiology (ACC)/American Heart Association (AHA) sudden cardiac death (SCD) risk models
- Outcome
- SCD risk prediction (c-statistic)
Performance
As reported in the abstract
SCD risk prediction, c-statistic
- Principal radiomics (PrinRads) vs ESC
- c-statistic 0.69 vs 0.57; P = 0.02
- PrinRads vs ACC/AHA
- c-statistic 0.69 vs 0.67; P = 0.75
- PrinRads + ESC vs ESC
- c-statistic 0.73 vs 0.57; P < 0.01
- PrinRads + ACC/AHA vs ACC/AHA
- c-statistic 0.76 vs 0.67; P < 0.01
Further findings
Individual predictors of SCD risk
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| One PrinRad | 0.57 (0.39–0.84) | P = 0.01 | |
| LGE heterogeneity · major component of PrinRads | 0.07 (0.01–0.75) | P = 0.03 | |
| 0.050.21520Hazard ratio (log scale) |
| Outcome | NRI (95% CI) | P value |
|---|---|---|
| Net reclassification index — PrinRads + ESC vs ESC | 0.25 (0.08–0.43) | P = 0.005 |
| Net reclassification index — PrinRads + ACC/AHA vs ACC/AHA | 0.05 (−0.07 to 0.16) | P = 0.42 |
SCD events · follow-up 49 ± 28 months
- SCD events, whole cohort
- 30 (2.4%)
Original publication
Radiomics of Late Gadolinium Enhancement Reveals Prognostic Value of Myocardial Scar Heterogeneity in Hypertrophic Cardiomyopathy. JACC Cardiovasc Imaging. Published 21 June 2023. doi:10.1016/j.jcmg.2023.05.003
Summarised from the published abstract; every number is checked against it