Heart failure & cardiomyopathies
Radiomics of Late Gadolinium Enhancement Reveals Prognostic Value of Myocardial Scar Heterogeneity in Hypertrophic Cardiomyopathy
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)
Methodological detailsmulticentre (3 centres)
- Multicentre (3 centres)
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.
Summarised from the published abstract; every number is checked against it