Quantitative cardiac magnetic resonance standardized signal intensity comparison in dilated cardiomyopathy vs. cardiac sarcoidosis.

IF 2.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Interventional Cardiac Electrophysiology Pub Date : 2025-05-06 DOI:10.1007/s10840-025-02042-7

Ting-Wei Ernie Liao, Lingyu Xu, Mirmilad Pourmousavi Khoshknab, Paul J Mather, Paco E Bravo, Benoit Desjardins, Saman Nazarian

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引用次数: 0

Abstract

Background: Dilated cardiomyopathy (DCM) and cardiac sarcoidosis (CS) manifest unique late gadolinium enhancement (LGE) patterns on cardiac magnetic resonance (CMR), indicative of different myocardial scar distributions. However, the overlap in these patterns due to their lack of specificity complicates differentiation. This study introduces a novel quantitative method employing z-score analysis of LGE-CMR intensity to objectively compare the spatial distribution of LGE intensity between DCM and CS.

Methods: This retrospective study included 22 NICM patients (13 DCM, 9 CS) who underwent CMR before electrophysiology study from November 2018 to May 2023. LGE images were delineated into sub-endocardial, mid-myocardial, and sub-epicardial layers across anterior, lateral, inferior, and septal walls using the AHA 17-segment model. CMR signal intensities were standardized to z-scores (z = (x - μ)/σ), with x as the signal intensity for a specific myocardial segment, and μ and σ as the mean and SD for all LV myocardial segments, to map regional intensity variations.

Results: Compared to DCM, CS patients exhibited significantly higher CMR signal intensity z-scores in the septum (β = 0.32, p = 0.009), particularly in the endocardial third of the right ventricular (RV) side (β = 0.56, p = 0.001). A z-score greater than 0.40 in this area was associated with a CS diagnosis, with an area under the ROC curve of 0.692 in fivefold cross-validation.

Conclusion: Patients with CS exhibit higher affinity for contrast in the septum, particularly on the RV endocardium. Standardized analysis of CMR signal intensities provides a novel, quantitative method for distinguishing CS from DCM, with the former exhibiting higher CMR signal intensity z-scores in the septum.

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扩张型心肌病与心脏结节病定量心脏磁共振标准化信号强度比较。

背景：扩张型心肌病（DCM）和心脏结节病（CS）在心脏磁共振（CMR）上表现出独特的晚期钆增强（LGE）模式，表明不同的心肌疤痕分布。然而，由于缺乏特异性，这些模式的重叠使分化复杂化。本研究引入了一种新的定量方法，采用LGE- cmr强度z-score分析来客观比较DCM和CS之间LGE强度的空间分布。方法：回顾性研究包括2018年11月至2023年5月22例NICM患者（13例DCM， 9例CS）在电生理研究前进行CMR。使用AHA 17节段模型将LGE图像划分为心内膜下层、心肌中层和心外膜下层，横跨前壁、外侧壁、下壁和间隔壁。CMR信号强度标准化为z分数（z = (x - μ)/σ），其中x为特定心肌段的信号强度，μ和σ为所有左室心肌段的均值和标准差，以绘制区域强度变化。结果：与DCM相比，CS患者在中隔的CMR信号强度z-评分明显更高（β = 0.32, p = 0.009），特别是在右心室（RV）侧的心内膜三分之一（β = 0.56, p = 0.001）。该区域的z分数大于0.40与CS诊断相关，五重交叉验证的ROC曲线下面积为0.692。结论：CS患者对中隔造影剂有较高的亲和力，尤其是右心室心内膜造影剂。CMR信号强度的标准化分析为区分CS和DCM提供了一种新的定量方法，前者在中隔显示更高的CMR信号强度z-评分。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.