The 4D B-spline method of calculating left ventricular functional parameters of cardiac MRI to evaluate myocardial injury of the apical segment in patients with myocarditis: a case-controlled observational study

Abstract

Background: Myocarditis does not have typical clinical manifestations and thus is difficult to accurately diagnose by virtue of infection history, and electrocardiogram (EKG) and peripheral blood abnormalities.Endomyocardial biopsy is the gold standard for diagnosis of myocarditis, but is invasive, high risk, and has an observational blind area. Cardiac magnetic resonance imaging (CMRI) is multiparameter and multidirectional with high spatial resolution and high contrast of soft tissue. However, the optimal method of calculating left ventricular (LV) function in patients with apical-segment-injured myocarditis is unresolved.We compared and analyzed the differences between two different methods (Simpson and 4D B-spline surface model (known as the 4D method)) of measuring LV function by CMRI in patients with myocarditis in the 17th segment of the left ventricle. Methods:The basic clinical data of two groups (myocarditis and non-myocarditis) were statistically analyzed, and differences in the LV function parameters by the two imaging methods were compared in the myocarditis group. Receiver-operating characteristic curves of single parameters and combined parameters based on the Simpson and 4D methods were drawn and the area under the curve, diagnostic threshold, maximum sensitivity interval, and maximum specificity interval were calculated.Results: In the myocarditis and non-myocarditis groups the respective number of patients was 22 and 17, the percentage of males was 54.55% and 47.06%, and the average age was 32.20±11.59 and 43.06±11.62 years. The difference in LV ejection fraction (LVEF) (P=0.033) and LV end systolic volume (LVESV) (P=0.030) in the myocarditis group was statistically significant. The respective AUCs based on the Simpson and 4D methods were LVEF 0.602 vs. 0.778, LVESV 0.556 vs. 0.751, LVEF-and-LVESV 0.634 vs. 0.775. Based on the 4D method, the diagnostic thresholds of LVEF and LVESV were 34.965 (sensitivity 0.882, specificity 0.591) and 69.090 (sensitivity 0.727, specificity 0.706), the maximum sensitivity intervals of LVEF and

Integration of cardiovascular risk assessment with COVID-19 using artificial intelligence

“…Nicol et al (2020) showed the role of cardiac MRI with T2-weighted mapping sequences in identification of focal lateral subepicardial late gadolinium enhancement and myocardial inflammation. Another study by Zhao et al (Zhao and Yuan, 2020) also showed the role of CMRI for computing the left ventricle (LV) function using 4-D imaging on myocarditis patients. In relation to myocarditis imaging in the COVID-19 era, there are many cases of AI-usage.…”

“…Also, closely knitted areas to CVD are genetics and microscopy. Genetics can be used to tackle the COVID-19 pandemic by tracking its origin (Cui et al, 2019;Phan, 2020;, finding reasons for the outbreak (Zhao and Yuan, 2020), and developing new vaccines (Álvarez-Machancoses et al, 2020;Hampel et al, 2020;Li et al, 2020c;Peng et al, 2020;Yan et al, 2020b;Yassine and Shah, 2020). Similarly, microscopy imaging is a very important part of AI-based COVID research for live-cell visualization to understand the behavior of SARS-CoV-2 (Lugagne et al, 2020;van Valen et al, 2016).…”

Relative basal myocardial weakness: differentiating dermatomyositis and polymyositis with cardiac involvement from viral myocarditis using speckle-tracking echocardiography and quantification of myocardial work

“…The AVM was further confirmed if cardiac magnetic resonance (CMR) imaging revealed myocardial edema. Endomyocardial biopsy (EMB) was not routinely performed for the diagnosis of AVM in our center (14). Since EMB was not routinely conducted, other etiologies were cautiously excluded.…”