Value of Cardiac Magnetic Resonance Fractal Analysis Combined With Myocardial Strain in Discriminating Isolated Left

Tian Zheng1, Xiaohai Ma2, Shuhao Li1

  • 1Department of Radiology, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China.

Insights

Fractal analysis quantitatively measures left ventricular trabeculation, aiding differentiation between left ventricular noncompaction (LVNC) and dilated cardiomyopathy (DCM). Combining fractal dimension with myocardial strain offers a novel biomarker for distinguishing these conditions.

Area of Science:

  • Cardiovascular Imaging
  • Biomedical Engineering
  • Quantitative Analysis

Background:

  • Distinguishing isolated left ventricular noncompaction (LVNC) from dilated cardiomyopathy (DCM) can be challenging due to excessive trabeculation in both conditions.
  • Fractal dimension (FD) offers a quantitative method to assess myocardial trabeculation extent.

Purpose of the Study:

  • To compare trabeculae features and myocardial strain using cardiac MRI between LVNC and DCM patients.
  • To evaluate the diagnostic utility of fractal analysis and myocardial strain in differentiating LVNC from DCM.

Main Methods:

  • Cardiac MRI with steady-state free precession cine imaging was performed on 35 LVNC patients, 30 DCM patients, and 20 healthy controls.
  • Left ventricular trabeculation was assessed using a semiautomatic fractal analysis tool.
  • Myocardial deformation was quantified using feature tracking to derive global peak longitudinal strain (GPLS).

Main Results:

  • Max apical FD and mean global FD were significantly higher in the LVNC group compared to the DCM group (P < 0.001).
  • FD values demonstrated good diagnostic accuracy for LVNC, with AUCs of 0.881 for max apical FD and 0.895 for mean global FD.
  • The combination of fractal analysis (FD) and GPLS achieved the highest diagnostic accuracy (AUC = 0.93) for differentiating LVNC from DCM.

Conclusions:

  • Fractal analysis provides a robust quantitative measure of myocardial trabeculation.
  • The integration of fractal analysis with myocardial strain parameters presents a promising novel biomarker for distinguishing LVNC from DCM.
Abstract

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