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Atlas-based quantification of cardiac remodeling due to myocardial infarction.

Zhang X, Cowan BR, Bluemke DA, Finn JP, Fonseca CG, Kadish AH, Lee DC, Lima JA, Suinesiaputra A, Young AA, Medrano-Gracia P - PLoS ONE (2014)

Bottom Line: Goodness of fit results obtained from end-diastolic and end-systolic shapes were compared against the traditional clinical indices of remodeling: end-diastolic volume, end-systolic volume and LV mass.The combination of end-diastolic and end-systolic shape parameter analysis achieved the lowest deviance, Akaike information criterion and Bayesian information criterion, and the highest area under the receiver operating characteristic curve.These features enable quantification of the amount of remodeling, the progression of disease over time, and the effect of treatments designed to reverse remodeling effects.

View Article: PubMed Central - PubMed

Affiliation: Department of Anatomy with Radiology, University of Auckland, Auckland, New Zealand.

ABSTRACT
Myocardial infarction leads to changes in the geometry (remodeling) of the left ventricle (LV) of the heart. The degree and type of remodeling provides important diagnostic information for the therapeutic management of ischemic heart disease. In this paper, we present a novel analysis framework for characterizing remodeling after myocardial infarction, using LV shape descriptors derived from atlas-based shape models. Cardiac magnetic resonance images from 300 patients with myocardial infarction and 1991 asymptomatic volunteers were obtained from the Cardiac Atlas Project. Finite element models were customized to the spatio-temporal shape and function of each case using guide-point modeling. Principal component analysis was applied to the shape models to derive modes of shape variation across all cases. A logistic regression analysis was performed to determine the modes of shape variation most associated with myocardial infarction. Goodness of fit results obtained from end-diastolic and end-systolic shapes were compared against the traditional clinical indices of remodeling: end-diastolic volume, end-systolic volume and LV mass. The combination of end-diastolic and end-systolic shape parameter analysis achieved the lowest deviance, Akaike information criterion and Bayesian information criterion, and the highest area under the receiver operating characteristic curve. Therefore, our framework quantitatively characterized remodeling features associated with myocardial infarction, better than current measures. These features enable quantification of the amount of remodeling, the progression of disease over time, and the effect of treatments designed to reverse remodeling effects.

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Related in: MedlinePlus

Image and shape differences for volunteers imaged from DETERMINE (top), and MESA (bottom), for the same short-axis (SA), long-axis (LA) planes at end diastole (ED) and end systole (ES).Green and blue contours and markers show the model's endocardial and epicardial boundaries and guide points, respectively. Light color markers denote fiducial landmarks (right ventricular free wall insertion points, mitral valve hinge points) used to define the location of the model shape parameters in consistent positions relative to the anatomy of the heart.
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pone-0110243-g001: Image and shape differences for volunteers imaged from DETERMINE (top), and MESA (bottom), for the same short-axis (SA), long-axis (LA) planes at end diastole (ED) and end systole (ES).Green and blue contours and markers show the model's endocardial and epicardial boundaries and guide points, respectively. Light color markers denote fiducial landmarks (right ventricular free wall insertion points, mitral valve hinge points) used to define the location of the model shape parameters in consistent positions relative to the anatomy of the heart.

Mentions: For the MESA cohort, short-axis hand-drawn contours on the inner and outer surfaces of the left ventricle were available from the MESA MRI core laboratory. These contours were fitted by the finite element model by linear least squares as described previously [20]. For the DETERMINE cohort, expert observers performed the analysis using guide-point modeling [13] to interactively customize a time-varying 3D cardiac finite element model of the LV to MR images (Figure 1) using custom software (CIM version 6.0, University of Auckland, New Zealand). LV mass and volume at ED and ES were subsequently calculated from the fitted cardiac LV shape models. The model comprised 16 bicubic finite elements with C1 continuity, (see [12], [13] for details). Briefly, the model was interactively fitted by least-squares optimization to guide points provided by the analyst, as well as computer-generated points calculated from the image using an edge detection algorithm. Automatic feature tracking was used to track points throughout the cardiac cycle using non-rigid registration in both short and long axis images [12]. The model was registered to each case using fiducial landmarks defined at the hinge points of the mitral valve and the insertions of the right ventricular free wall into the inter-ventricular septum. This method has been previously validated against autopsy LV mass, in patients against manually drawn contours and in healthy volunteers against flow-derived measurements of cardiac output [13]. The finite element coordinates were used to provide the atlas coordinates of the LV: each point was assumed to be in approximately the same anatomical location in every heart [21].


Atlas-based quantification of cardiac remodeling due to myocardial infarction.

Zhang X, Cowan BR, Bluemke DA, Finn JP, Fonseca CG, Kadish AH, Lee DC, Lima JA, Suinesiaputra A, Young AA, Medrano-Gracia P - PLoS ONE (2014)

Image and shape differences for volunteers imaged from DETERMINE (top), and MESA (bottom), for the same short-axis (SA), long-axis (LA) planes at end diastole (ED) and end systole (ES).Green and blue contours and markers show the model's endocardial and epicardial boundaries and guide points, respectively. Light color markers denote fiducial landmarks (right ventricular free wall insertion points, mitral valve hinge points) used to define the location of the model shape parameters in consistent positions relative to the anatomy of the heart.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4215861&req=5

pone-0110243-g001: Image and shape differences for volunteers imaged from DETERMINE (top), and MESA (bottom), for the same short-axis (SA), long-axis (LA) planes at end diastole (ED) and end systole (ES).Green and blue contours and markers show the model's endocardial and epicardial boundaries and guide points, respectively. Light color markers denote fiducial landmarks (right ventricular free wall insertion points, mitral valve hinge points) used to define the location of the model shape parameters in consistent positions relative to the anatomy of the heart.
Mentions: For the MESA cohort, short-axis hand-drawn contours on the inner and outer surfaces of the left ventricle were available from the MESA MRI core laboratory. These contours were fitted by the finite element model by linear least squares as described previously [20]. For the DETERMINE cohort, expert observers performed the analysis using guide-point modeling [13] to interactively customize a time-varying 3D cardiac finite element model of the LV to MR images (Figure 1) using custom software (CIM version 6.0, University of Auckland, New Zealand). LV mass and volume at ED and ES were subsequently calculated from the fitted cardiac LV shape models. The model comprised 16 bicubic finite elements with C1 continuity, (see [12], [13] for details). Briefly, the model was interactively fitted by least-squares optimization to guide points provided by the analyst, as well as computer-generated points calculated from the image using an edge detection algorithm. Automatic feature tracking was used to track points throughout the cardiac cycle using non-rigid registration in both short and long axis images [12]. The model was registered to each case using fiducial landmarks defined at the hinge points of the mitral valve and the insertions of the right ventricular free wall into the inter-ventricular septum. This method has been previously validated against autopsy LV mass, in patients against manually drawn contours and in healthy volunteers against flow-derived measurements of cardiac output [13]. The finite element coordinates were used to provide the atlas coordinates of the LV: each point was assumed to be in approximately the same anatomical location in every heart [21].

Bottom Line: Goodness of fit results obtained from end-diastolic and end-systolic shapes were compared against the traditional clinical indices of remodeling: end-diastolic volume, end-systolic volume and LV mass.The combination of end-diastolic and end-systolic shape parameter analysis achieved the lowest deviance, Akaike information criterion and Bayesian information criterion, and the highest area under the receiver operating characteristic curve.These features enable quantification of the amount of remodeling, the progression of disease over time, and the effect of treatments designed to reverse remodeling effects.

View Article: PubMed Central - PubMed

Affiliation: Department of Anatomy with Radiology, University of Auckland, Auckland, New Zealand.

ABSTRACT
Myocardial infarction leads to changes in the geometry (remodeling) of the left ventricle (LV) of the heart. The degree and type of remodeling provides important diagnostic information for the therapeutic management of ischemic heart disease. In this paper, we present a novel analysis framework for characterizing remodeling after myocardial infarction, using LV shape descriptors derived from atlas-based shape models. Cardiac magnetic resonance images from 300 patients with myocardial infarction and 1991 asymptomatic volunteers were obtained from the Cardiac Atlas Project. Finite element models were customized to the spatio-temporal shape and function of each case using guide-point modeling. Principal component analysis was applied to the shape models to derive modes of shape variation across all cases. A logistic regression analysis was performed to determine the modes of shape variation most associated with myocardial infarction. Goodness of fit results obtained from end-diastolic and end-systolic shapes were compared against the traditional clinical indices of remodeling: end-diastolic volume, end-systolic volume and LV mass. The combination of end-diastolic and end-systolic shape parameter analysis achieved the lowest deviance, Akaike information criterion and Bayesian information criterion, and the highest area under the receiver operating characteristic curve. Therefore, our framework quantitatively characterized remodeling features associated with myocardial infarction, better than current measures. These features enable quantification of the amount of remodeling, the progression of disease over time, and the effect of treatments designed to reverse remodeling effects.

Show MeSH
Related in: MedlinePlus