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Published on: December 11, 2016
Apical conicity ratio: a new index on left ventricular apical geometry after myocardial infarction
Hongguang Fan1, Zhe Zheng, Wei Feng
1Department of Cardiovascular Surgery and Research Center for Cardiovascular Regenerative Medicine, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
Insights
A new index, the apical conicity ratio, effectively quantifies left ventricular aneurysm by analyzing apical geometry. This novel tool aids in diagnosing left ventricular aneurysm, particularly after myocardial infarction.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Left ventricular aneurysm (LVA) assessment is crucial for managing ischemic heart disease.
- Current methods for evaluating LVA geometry have limitations.
Purpose of the Study:
- To introduce and validate a novel index, the apical conicity ratio (ACR), for quantitative analysis of left ventricular apical geometry.
- To assess the efficacy of ACR in differentiating LVA from normal or other conditions.
Main Methods:
- Magnetic resonance imaging (MRI) was performed on 116 subjects, including healthy volunteers, patients with dilated cardiomyopathy, and patients with ischemic heart disease (with and without LVA).
- The apical conicity ratio was calculated as the ratio of left ventricular apical area to the apical triangle area.
- Global indices and ACR were compared between groups, and receiver operating characteristic (ROC) curves were generated.
Main Results:
- Patients with LVA exhibited significantly higher ACR compared to those without LVA, even when other global indices showed no difference.
- Post-left ventricular reconstruction, ACR values in LVA patients decreased towards normal levels.
- ROC analysis demonstrated that ACR had high discriminatory power for LVA.
Conclusions:
- The apical conicity ratio is a valuable index for quantifying regional left ventricular deformation.
- ACR is particularly useful for evaluating left ventricular aneurysm resulting from myocardial infarction.
- This novel index offers improved diagnostic capability for LVA.
Objective:
Our objective was to introduce a new index to evaluate left ventricular aneurysm by quantitative analysis of left ventricular apical geometry.
Methods:
A total of 116 selected subjects underwent magnetic resonance imaging, 28 healthy volunteers, 29 patients with dilated cardiomyopathy, and 59 patients with ischemic heart disease (26 with left ventricular aneurysm; 33 with no aneurysm). The apical conicity ratio was calculated as the ratio of left ventricular apical area over apical triangle.
Results:
Diastolic apical conicity ratio of patients with left ventricular aneurysm was 1.62 ± 0.20 and systolic apical conicity ratio was 1.78 ± 0.43. After left ventricular reconstruction, the diastolic apical conicity ratio decreased to 1.47 ± 0.23 and the systolic ratio to 1.51 ± 0.21, which came close to the normal level, whereas other global indices remained. In patients with dilated cardiomyopathy, sphericity index and eccentricity index increased significantly without changes in the apical conicity ratio. Among patients with ischemic heart disease, the apical conicity ratio of the group with left ventricular aneurysm was significantly higher than that of the group without an aneurysm when the other indices between the 2 groups showed no statistically difference. Receiver operating characteristic curves showed only apical conicity ratio had high power of discriminating left ventricular aneurysm from no aneurysm.
Conclusions:
The new index, apical conicity ratio, can be used to quantify the regional left ventricular deformation, especially in patients with left ventricular aneurysm resulting from myocardial infarction.
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