Pericardial Fat Radiomics to Predict Left Ventricular Involvement and Provide Incremental Prognostic Value in ARVC.

Area of Science:

• Cardiology
• Medical Imaging
• Radiology

Background:

• Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a heritable heart muscle disease.
• Left ventricular (LV) involvement and major adverse cardiac events (MACE) are critical indicators of ARVC prognosis.
• Non-invasive imaging biomarkers for predicting ARVC outcomes are needed.

Purpose of the Study:

• To investigate the predictive capability of pericardial fat tissue (PFT) radiomics for LV involvement in ARVC.
• To assess the association between PFT radiomics and MACE in ARVC patients.
• To develop a risk stratification tool combining PFT radiomics and right ventricular ejection fraction (RVEF).

Main Methods:

• Retrospective multicenter study analyzing 122 ARVC patients.
• Cardiac magnetic resonance (CMR) used for LV involvement assessment.
• A radiomic score (RS) from PFT was developed and validated to predict LV involvement and MACE.

Main Results:

• The PFT radiomic score (RS) effectively predicted LV involvement in both development and test sets (AUCs 0.771 and 0.785).
• A high RS was independently associated with increased MACE risk over 5 years (HR 3.452, p < 0.001).
• A simplified risk score integrating RVEF and RS categorized patients into low, intermediate, and high-risk groups.

Conclusions:

• PFT radiomics serves as a valuable tool for predicting LV involvement in ARVC.
• PFT radiomics is significantly associated with MACE, offering prognostic information.
• The combined risk score aids in stratifying ARVC patient risk for improved management.