title: Atlas-based quantification of cardiac remodeling due to myocardial infarction.
abstract: Myocardial infarction leads to changes in the geometry (remodeling) of the left ventricle (LV) of the heart. The degree and type of remodeling provides important diagnostic information for the therapeutic management of ischemic heart disease. In this paper, we present a novel analysis framework for characterizing remodeling after myocardial infarction, using LV shape descriptors derived from atlas-based shape models. Cardiac magnetic resonance images from 300 patients with myocardial infarction and 1991 asymptomatic volunteers were obtained from the Cardiac Atlas Project. Finite element models were customized to the spatio-temporal shape and function of each case using guide-point modeling. Principal component analysis was applied to the shape models to derive modes of shape variation across all cases. A logistic regression analysis was performed to determine the modes of shape variation most associated with myocardial infarction. Goodness of fit results obtained from end-diastolic and end-systolic shapes were compared against the traditional clinical indices of remodeling: end-diastolic volume, end-systolic volume and LV mass. The combination of end-diastolic and end-systolic shape parameter analysis achieved the lowest deviance, Akaike information criterion and Bayesian information criterion, and the highest area under the receiver operating characteristic curve. Therefore, our framework quantitatively characterized remodeling features associated with myocardial infarction, better than current measures. These features enable quantification of the amount of remodeling, the progression of disease over time, and the effect of treatments designed to reverse remodeling effects.
authors.affiliation: Department of Anatomy with Radiology, University of Auckland, Auckland, New Zealand.
authors.forename: Xingyu
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Anatomy with Radiology, University of Auckland, Auckland, New Zealand.
authors.forename: Brett R
authors.initials: BR
authors.lastname: Cowan
authors.affiliation: National Institute of Biomedical Imaging and Bioengineering, Bethesda, Maryland, United States of America.
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.affiliation: Department of Radiology, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: J Paul
authors.initials: JP
authors.lastname: Finn
authors.affiliation: Department of Radiology, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Carissa G
authors.initials: CG
authors.lastname: Fonseca
authors.affiliation: Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America.
authors.forename: Alan H
authors.initials: AH
authors.lastname: Kadish
authors.affiliation: Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Lee
authors.affiliation: The Donald W. Reynolds Cardiovascular Clinical Research Center, The Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Joao A C
authors.initials: JA
authors.lastname: Lima
authors.affiliation: Department of Anatomy with Radiology, University of Auckland, Auckland, New Zealand.
authors.forename: Avan
authors.initials: A
authors.lastname: Suinesiaputra
authors.affiliation: Department of Anatomy with Radiology, University of Auckland, Auckland, New Zealand.
authors.forename: Alistair A
authors.initials: AA
authors.lastname: Young
authors.affiliation: Department of Anatomy with Radiology, University of Auckland, Auckland, New Zealand.
authors.forename: Pau
authors.initials: P
authors.lastname: Medrano-Gracia
mesh_terms: D058070:Asymptomatic Diseases; D005260:Female; D020342:Finite Element Analysis; D006801:Humans; D021621:Imaging, Three-Dimensional; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009068:Movement; D009203:Myocardial Infarction / Q000473:pathology* / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology; D009929:Organ Size; D025341:Principal Component Analysis; D020257:Ventricular Remodeling