PMID- 38499900
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240321
IS  - 1869-4101 (Print)
IS  - 1869-4101 (Electronic)
IS  - 1869-4101 (Linking)
VI  - 15
IP  - 1
DP  - 2024 Mar 18
TI  - Fractal analysis of left ventricular trabeculae in post-STEMI: from acute to 
      chronic phase.
PG  - 75
LID - 10.1186/s13244-024-01641-8 [doi]
LID - 75
AB  - PURPOSE: The temporal evolution of ventricular trabecular complexity and its 
      correlation with major adverse cardiovascular events (MACE) remain indeterminate 
      in patients presenting with acute ST elevation myocardial infarction (STEMI). 
      METHODS: This retrospective analysis enrolled patients undergoing primary 
      percutaneous coronary intervention (pPCI) for acute STEMI, possessing cardiac 
      magnetic resonance (CMR) data in the acute (within 7 days), subacute (1 month 
      after pPCI), and chronic phases (6 months after pPCI) from January 2015 to 
      January 2020 at the three participating sites. Fractal dimensions (FD) were 
      measured for the global, infarct, and remote regions of left ventricular 
      trabeculae during each phase. The potential association of FD with MACE was 
      analyzed using multivariate Cox regression. RESULTS: Among the 200 analyzed 
      patients (182 men; median age, 61 years; age range, 50-66 years), 37 (18.5%) 
      encountered MACE during a median follow-up of 31.2 months. FD exhibited a gradual 
      decrement (global FD at acute, subacute, and chronic phases: 1.253 +/- 0.049, 
      1.239 +/- 0.046, 1.230 +/- 0.045, p < 0.0001), with a more pronounced decrease 
      observed in patients subsequently experiencing MACE (p < 0.001). The global FD at 
      the subacute phase correlated with MACE (hazard ratio 0.89 (0.82, 0.97), 
      p = 0.01), and a global FD value below 1.26 was associated with a heightened 
      risk. CONCLUSION: In patients post-STEMI, the global FD, serving as an indicator 
      of left ventricular trabeculae complexity, independently demonstrated an 
      association with subsequent major adverse cardiovascular events, beyond factors 
      encompassing left ventricular ejection fraction, indexed left ventricular 
      end-diastolic volume, infarct size, heart rate, NYHA class, and post-pPCI TIMI 
      flow. CRITICAL RELEVANCE STATEMENT: In patients who have had an ST-segment 
      elevation myocardial infarction, global fractal dimension, as a measure of left 
      ventricular trabeculae complexity, provided independent association with 
      subsequent major adverse cardiovascular event. KEY POINTS: * Global and regional 
      FD decreased after STEMI, and more so in patients with subsequent MACE. * Lower 
      global FD at the subacute phase and Deltaglobal FD from acute to subacute phase were 
      associated with subsequent MACE besides clinical and CMR factors. * Global FD at 
      the subacute phase independently correlated with MACE and global FD value below 
      1.26 was associated with higher risk.
CI  - (c) 2024. The Author(s).
FAU - Shi, Ruo-Yang
AU  - Shi RY
AD  - Department of Radiology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong 
      University, No. 160, Pujian Road, Shanghai, 200127, China.
AD  - Jiading Branch, Ren Ji Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai, China.
FAU - Wu, Rui
AU  - Wu R
AD  - Department of Radiology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong 
      University, No. 160, Pujian Road, Shanghai, 200127, China.
FAU - Ran, Jinjun
AU  - Ran J
AD  - School of Public Health, Shanghai Jiao Tong University School of Medicine, 
      Shanghai, China.
FAU - Tang, Lang-Lang
AU  - Tang LL
AD  - Department of Radiology, Longyan First Hospital of Fujian Medical University, 
      Long Yan, Fu Jian, China.
FAU - Wesemann, Luke
AU  - Wesemann L
AD  - Department of Radiology, Wayne State University, Detroit, MI, USA.
FAU - Hu, Jiani
AU  - Hu J
AD  - Department of Radiology, Wayne State University, Detroit, MI, USA.
FAU - Du, Liang
AU  - Du L
AD  - Shanghai Robotics Institute, Shanghai University, Shanghai, China.
FAU - Zhang, Wei-Jun
AU  - Zhang WJ
AD  - School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China.
FAU - Xu, Jian-Rong
AU  - Xu JR
AD  - Department of Radiology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong 
      University, No. 160, Pujian Road, Shanghai, 200127, China.
FAU - Zhou, Yan
AU  - Zhou Y
AD  - Department of Radiology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong 
      University, No. 160, Pujian Road, Shanghai, 200127, China.
FAU - Zhao, Lei
AU  - Zhao L
AD  - Department of Radiology, An Zhen Hospital, Capital Medical University, No. 2 
      Anzhen Road, Beijing, 100029, China. zhaolei_anzhen@outlook.com.
FAU - Pu, Jun
AU  - Pu J
AD  - Department of Cardiology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong 
      University, No. 160, Pujian Road, Shanghai, 200127, China. pujun310@outlook.com.
FAU - Wu, Lian-Ming
AU  - Wu LM
AUID- ORCID: 0000-0001-7381-5436
AD  - Department of Radiology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong 
      University, No. 160, Pujian Road, Shanghai, 200127, China. wu_lianming@126.com.
LA  - eng
GR  - YG2022QN020/Shanghai Jiao Tong University Medical Engineering cross fund/
GR  - 22YF1438600/Shanghai Sailing Program/
GR  - 82171884/National Natural Science Foundation of China/
GR  - 82302174/National Natural Science Foundation of China Youth Project/
GR  - 19DZ2203800/Shanghai science and technology innovation action plan, technology 
      standard project/
GR  - 20Y11912200/Shanghai science and technology innovation action plan/
PT  - Journal Article
DEP - 20240318
PL  - Germany
TA  - Insights Imaging
JT  - Insights into imaging
JID - 101532453
PMC - PMC10948656
OTO - NOTNLM
OT  - Cine
OT  - Fractals
OT  - Magnetic resonance imaging
OT  - Myocardium
OT  - ST elevation myocardial infarction
COIS- L.D. works for Shanghai Robotics Institute. The remaining authors declare that 
      they have no competing interests.
EDAT- 2024/03/19 06:43
MHDA- 2024/03/19 06:44
PMCR- 2024/03/18
CRDT- 2024/03/19 00:37
PHST- 2023/07/11 00:00 [received]
PHST- 2024/02/09 00:00 [accepted]
PHST- 2024/03/19 06:44 [medline]
PHST- 2024/03/19 06:43 [pubmed]
PHST- 2024/03/19 00:37 [entrez]
PHST- 2024/03/18 00:00 [pmc-release]
AID - 10.1186/s13244-024-01641-8 [pii]
AID - 1641 [pii]
AID - 10.1186/s13244-024-01641-8 [doi]
PST - epublish
SO  - Insights Imaging. 2024 Mar 18;15(1):75. doi: 10.1186/s13244-024-01641-8.