Radiomics Analysis of Pericoronary Adipose Tissue From Baseline Coronary Computed Tomography Angiography Enables Prediction of Coronary Plaque Progression.

PURPOSE: The relationship between plaque progression and pericoronary adipose tissue (PCAT) radiomics has not been comprehensively evaluated. We aim to predict plaque progression with PCAT radiomics features and evaluate their incremental value over quantitative plaque characteristics. PATIENTS AND METHODS: Between January 2009 and December 2020, 500 patients with suspected or known coronary artery disease who underwent serial coronary computed tomography angiography (CCTA) ≥2 years apart were retrospectively analyzed and randomly stratified into a training and testing data set with a ratio of 7:3. Plaque progression was defined with annual change in plaque burden exceeding the median value in the entire cohort. Quantitative plaque characteristics and PCAT radiomics features were extracted from baseline CCTA. Then we built 3 models including quantitative plaque characteristics (model 1), PCAT radiomics features (model 2), and the combined model (model 3) to compare the prediction performance evaluated by area under the curve. RESULTS: The quantitative plaque characteristics of the training set showed the values of noncalcified plaque volume (NCPV), fibrous plaque volume, lesion length, and PCAT attenuation were larger in the plaque progression group than in the nonprogression group ( P < 0.05 for all). In multivariable logistic analysis, NCPV and PCAT attenuation were independent predictors of coronary plaque progression. PCAT radiomics exhibited significantly superior prediction over quantitative plaque characteristics both in the training (area under the curve: 0.814 vs 0.615, P < 0.001) and testing (0.736 vs 0.594, P = 0.007) data sets. CONCLUSIONS: NCPV and PCAT attenuation were independent predictors of coronary plaque progression. PCAT radiomics derived from baseline CCTA achieved significantly better prediction than quantitative plaque characteristics.

Predicting coronary plaque progression with conventional plaque parameters and radiomics features derived from coronary CT angiography.

OBJECTIVES: To determine the value of combining conventional plaque parameters and radiomics features derived from coronary computed tomography angiography (CCTA) for predicting coronary plaque progression. MATERIALS AND METHODS: Clinical data and CCTA images of 400 patients who underwent at least two CCTA examinations between January 2009 and August 2020 were analyzed retrospectively. Diameter stenosis, total plaque volume and burden, calcified plaque volume and burden, noncalcified plaque volume and burden (NCPB), pericoronary fat attenuation index (FAI), and other conventional plaque parameters were recorded. The patients were assigned to a training cohort (n = 280) and a validation cohort (n = 120) in a 7:3 ratio using a stratified random splitting method. The area under the receiver operating characteristics curve (AUC) was used to evaluate the predictive abilities of conventional parameters (model 1), radiomics features (model 2), and their combination (model 3). RESULTS: FAI and NCPB were identified as independent risk factors for coronary plaque progression in the training cohort. Both model 2 (training cohort AUC: 0.814, p < 0.001; validation cohort AUC: 0.729, p = 0.288) and model 3 (training cohort AUC: 0.824, p < 0.001; validation cohort AUC: 0.758, p = 0.042) had better diagnostic performances in predicting plaque progression than model 1 (training cohort AUC: 0.646; validation cohort AUC: 0.654). Moreover, model 3 was slightly higher than model 2, although not statistically significant. CONCLUSIONS: The combination of conventional coronary plaque parameters and CCTA-derived radiomics features had a better ability to predict plaque progression than conventional parameters alone. CLINICAL RELEVANCE STATEMENT: The conventional coronary plaque characteristics such as noncalcified plaque burden, pericoronary fat attenuation index, and radiomics features derived from CCTA can identify plaques prone to progression, which is helpful for further clinical decision-making of coronary artery disease. KEY POINTS: • FAI and NCPB were identified as independent risk factors for predicting plaque progression. • Coronary plaque radiomics features were more advantageous than conventional parameters in predicting plaque progression. • The combination of conventional coronary plaque parameters and radiomics features could significantly improve the predictive ability of plaque progression over conventional parameters alone.

Early cardiac involvement detected by cardiac magnetic resonance feature tracking in idiopathic inflammatory myopathy with preserved ejection fraction.

Cardiac involvement is common in idiopathic inflammatory myopathy (IIM) but often subclinical. Cardiac magnetic resonance (CMR) is a promising tool in detecting cardiac involvement in patients with IIM. The aim of this study was to assess cardiac involvement in IIM patients by CMR feature tracking (CMR-FT). Thirty-seven IIM patients and 25 controls were enrolled in this retrospective study. The left ventricular (LV) functional parameters such as volume and ejection fraction were measured. Global and regional LV peak strain (PS) in radial, circumferential and longitudinal directions were derived from cine images. Left atrial (LA) volume, longitudinal strain and strain rate (SR) parameters and LA reservoir function, conduit function and booster pump function were assessed, respectively. IIM patients with preserved LVEF showed significantly reduced global and regional LV PS in longitudinal direction (all p < 0.05). Compared with controls, LA reservoir and conduit function were significantly impaired in IIM patients (all p < 0.05). The global LV longitudinal PS, LAVpre-ac and SRe were independent predictors of IIM. By Pearson's correlation analysis, the LV global radial, circumferential and longitudinal PS were all correlated to LVEF in IIM patients (r = 0.526, p < 0.001 vs. r = - 0.514, p < 0.001 vs. r = - 0.288, p = 0.023). CMR-FT based LV and LA deformation performance could early detect cardiac involvement in IIM patients with preserved LVEF.

The diagnostic value of serum YKL-40 for myocardial involvement in idiopathic inflammatory myopathy.

OBJECTIVE: To investigate the diagnostic value of serum chitinase-3-like-1 protein (YKL-40) levels for myocardial involvement in idiopathic inflammatory myopathies (IIM). METHODS: A total of 74 patients with definite IIM who visited Jiangsu Province People's Hospital between May 2018 and January 2022 were enrolled in this retrospective study. Baseline clinical evaluation, laboratory index, electrocardiogram (ECG), echocardiography (ECHO) and cardiac magnetic resonance (CMR) parameters were collected. Serum YKL-40 of all participants was determined by ELISA. Receiver-operating characteristic (ROC) curve was used to assess the diagnostic value of YKL-40 in assessing myocardial involvement in IIM patients. RESULTS: 1. YKL-40 concentration was significantly higher in IIM patients with myocardial injury than without myocardial injury.2. Multivariate logistic regression analysis demonstrated that serum YKL-40 was an independent risk factor for myocardial involvement in IIM.3. YKL-40 > 66.4 ng/ml (AUC = 0.85, 95 % CI 0.75-0.95) predicted myocardial injury in IIM with a sensitivity of 0.75 and specificity of 0.95. CONCLUSION: Serum YKL-40 could serve as a potential biomarker to predict myocardial injury in IIM patients.

Myocardial involvement characteristics by cardiac MR imaging in patients with polymyositis and dermatomyositis.

OBJECTIVE: Myocardial involvement is frequently observed in PM and DM but typically remains subclinical. This study aimed to investigate characteristics of myocardial involvement and compare differences between patients with PM and DM by cardiac MR (CMR) imaging. METHODS: From March 2017 to December 2019, a total of 17 PM and 27 DM patients were enrolled in this retrospective study. In all patients, clinical assessment and CMR examination were performed. CMR parameters, including left ventricular (LV) morphologic and functional parameters, and CMR tissue characterization imaging parameters, such as native T1, T2, extracellular volume (ECV) and late gadolinium enhancement, were analysed. RESULTS: In patients in both PM and DM groups, elevated global native T1 and ECV values were observed. Global ECV values were higher in the PM group when compared with the DM group (33.24 ± 2.97% vs 30.36 ± 4.20%; P = 0.039). Furthermore, patients in the PM and DM groups showed a different positive segment distribution of late gadolinium enhancement, native T1 and ECV, whereas the number of positive segments in PM patients was greater compared with that in DM patients. No significant differences in LV morphological and functional parameters were observed between patients in PM and DM groups, and most were in normal range. CONCLUSION: CMR tissue characterization imaging could detect early myocardial involvement in PM and DM patients without overt LV dysfunction. Furthermore, characteristics of myocardial involvement were different between PM and DM patients with more serious myocardial involvement seen in PM patients.