Academic radiology · 2026
Prognostic Value of Scar Spatial Properties on CMR for Major Adverse Cardiovascular Events After Myocardial Infarction.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zhao Xiaoying, Wang Lujing, Chen Wei, Song Yujiao, Liu Pei, Chen Siwen, Chen Mingtian, Song Linsheng, Zhao Xinxiang
Аннотация
RATIONALE AND OBJECTIVES: The border zone (BZ) assessed by cardiac magnetic resonance (CMR) is the critical substrate for major adverse cardiac events (MACEs) in post-myocardial infarction (MI) patients. However, conventional BZ characterization fails to capture the spatial properties of abnormal electrical conduction BZC. The study aims to evaluate ADAS 3D-quantified BZ channel (BZC) spatial features as novel MACEs predictors.
MATERIALS AND METHODS: This retrospective study included post-MI patients with ADAS 3D post-processing analysis confirming the presence of BZC. Primary endpoint events include composite arrhythmic outcomes, while secondary endpoints incorporated these events plus all-cause mortality and heart failure (HF) rehospitalization. The scar spatial properties (BZC number, mass, length, transmurality, and complexity score) were quantitatively obtained based on the late gadolinium enhancement (LGE) images using the ADAS 3D software. To establish robust prognostic models, candidate variables were first screened via univariate Cox regression (p < 0.1) followed by Least Absolute Shrinkage and Selection Operator (LASSO)-Cox regression with the λ1se penalty criterion to minimize overfitting. The optimal predictive model was constructed based on the retained features. Model performance was comprehensively evaluated using time-dependent Harrell's C-index, calibration curves (validated by 1000 bootstrap) and decision curve analysis (DCA) to assess its discriminative ability and clinical utility.
RESULTS: During a median follow-up of 34 months, 69 patients experienced secondary endpoint events, including 36 with primary endpoint events. Patients with endpoint events demonstrated significantly impaired global longitudinal strain(GLS) and left atrioventricular coupling index (LACI), greater scar mass, and higher BZC spatial characteristics(all p < 0.05). Via LASSO-Cox regression with the λ1se penalty criterion, only total BZC mass was independently associated with primary and secondary endpoints. Time-dependent C-index curves, calibration curves and DCA indicated that the total BZC mass provided great discriminative ability for predicting both endpoint events.
CONCLUSION: ADAS 3D-derived scar spatial characteristics were independently predictive of post-MI MACE and demonstrated discriminatory performance beyond conventional CMR scar parameters.
MATERIALS AND METHODS: This retrospective study included post-MI patients with ADAS 3D post-processing analysis confirming the presence of BZC. Primary endpoint events include composite arrhythmic outcomes, while secondary endpoints incorporated these events plus all-cause mortality and heart failure (HF) rehospitalization. The scar spatial properties (BZC number, mass, length, transmurality, and complexity score) were quantitatively obtained based on the late gadolinium enhancement (LGE) images using the ADAS 3D software. To establish robust prognostic models, candidate variables were first screened via univariate Cox regression (p < 0.1) followed by Least Absolute Shrinkage and Selection Operator (LASSO)-Cox regression with the λ1se penalty criterion to minimize overfitting. The optimal predictive model was constructed based on the retained features. Model performance was comprehensively evaluated using time-dependent Harrell's C-index, calibration curves (validated by 1000 bootstrap) and decision curve analysis (DCA) to assess its discriminative ability and clinical utility.
RESULTS: During a median follow-up of 34 months, 69 patients experienced secondary endpoint events, including 36 with primary endpoint events. Patients with endpoint events demonstrated significantly impaired global longitudinal strain(GLS) and left atrioventricular coupling index (LACI), greater scar mass, and higher BZC spatial characteristics(all p < 0.05). Via LASSO-Cox regression with the λ1se penalty criterion, only total BZC mass was independently associated with primary and secondary endpoints. Time-dependent C-index curves, calibration curves and DCA indicated that the total BZC mass provided great discriminative ability for predicting both endpoint events.
CONCLUSION: ADAS 3D-derived scar spatial characteristics were independently predictive of post-MI MACE and demonstrated discriminatory performance beyond conventional CMR scar parameters.