Predicting ventricular tachyarrhythmia in patients with systolic heart failure based on texture features of the gray zone from contrast-enhanced magnetic resonance imaging

Van-Truong Pham; Chen Lin; Thi-Thao Tran; Mao-Yuan M Su; Ying-Kuang Lin; Chun-Tung Nien; Wen-Yih I Tseng; Jiunn-Lee Lin; Men-Tzung Lo; Lian-Yu Lin

doi:10.1016/j.jjcc.2020.06.020

Predicting ventricular tachyarrhythmia in patients with systolic heart failure based on texture features of the gray zone from contrast-enhanced magnetic resonance imaging

J Cardiol. 2020 Dec;76(6):601-609. doi: 10.1016/j.jjcc.2020.06.020. Epub 2020 Jul 14.

Authors

Affiliations

¹ School of Electrical Engineering, Hanoi University of Science and Technology, Hanoi, Vietnam; Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan.
² Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan; Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan. Electronic address: clin@ncu.edu.tw.
³ Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
⁴ Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan; Department of Medicine, Taiwan Landseed Hospital, Taoyuan, Taiwan.
⁵ Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan; Center for Optoelectronic Biomedicine, National Taiwan University College of Medicine, Taipei, Taiwan.
⁶ Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.
⁷ Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan.
⁸ Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan. Electronic address: hspenos@gmail.com.

PMID: 32675026
DOI: 10.1016/j.jjcc.2020.06.020

Abstract

Background: Previous research showed that gray zone detected by late gadolinium enhancement cardiovascular magnetic resonance (LGE-CMR) imaging could help identify high-risk patients. In this study, we investigated whether LGE-CMR gray zone heterogeneity measured by image texture features could predict cardiovascular events in patients with heart failure (HF).

Method: This is a retrospective cohort study. Patients with systolic HF undergoing CMR imaging were enrolled. Cine and LGE images were analyzed to derive left ventricular (LV) function and scar characteristics. Entropy and uniformity of gray zones were derived by texture analysis.

Results: A total of 82 systolic HF patients were enrolled. After a median 1021 (25%-75% quartiles, 205-2066) days of follow-up, the entropy (0.60 ± 0.260 vs. 0.87 ± 0.28, p = 0.013) was significantly increased while the uniformity (0.68 ± 0.14 vs. 0.53±0.15, p = 0.016) was significantly decreased in patients with ventricular tachycardia or ventricular fibrillation (VT/VF). The percentage of core scar (21.9 ± 10.6 vs. 30.6 ± 10.4, p = 0.029) was higher in cardiac mortality group than survival group while the uniformity (0.55 ± 0.17 vs. 0.67 ± 0.14, p = 0.018) was lower in cardiac mortality group than survival group. A multivariate Cox regression model showed that higher percentage of gray zone area (HR = 8.805, 1.620-47.84, p = 0.045), higher entropy (>0.85) (HR = 1.391, 1.092-1.772, p = 0.024) and lower uniformity (≦0.54) (HR = 0.535, 0.340-0.842, p = 0.022) were associated with VT/VF attacks. Also, higher percentage of gray zone area (HR = 5.716, 1.379-23.68, p = 0.017), core scar zone (HR = 1.939, 1.056-3.561, p = 0.025), entropy (>0.85) (HR = 1.434, 1.076-1.911, p = 0.008) and lower uniformity (≦0.54) (HR = 0.513, 0.296-0.888, p = 0.009) were associated with cardiac mortality during follow-up.

Conclusions: Gray zone heterogeneity by texture analysis method could provide additional prognostic value to traditional LGE-CMR substrate analysis method.

Keywords: Congestive heart failure; Gray zone heterogeneity; Magnetic resonance imaging; Texture features; Ventricular tachyarrhythmia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Arrhythmias, Cardiac / diagnostic imaging*
Arrhythmias, Cardiac / physiopathology
Contrast Media
Female
Gadolinium
Heart Failure, Systolic / diagnostic imaging*
Heart Failure, Systolic / physiopathology
Humans
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Prognosis
Retrospective Studies
Ventricular Function, Left

Substances

Contrast Media
Gadolinium