Association of increased epicardial adipose tissue derived from cardiac magnetic resonance imaging with myocardial fibrosis in Duchenne muscular dystrophy: a clinical prediction model development and validation study in 283 participants.

Duchenne muscular dystrophy (DMD) cardiac magnetic resonance (CMR) epicardial adipose tissue (EAT) myocardial fibrosis prediction model

Journal

Quantitative imaging in medicine and surgery
ISSN: 2223-4292
Titre abrégé: Quant Imaging Med Surg
Pays: China
ID NLM: 101577942

Informations de publication

Date de publication:
03 Jan 2024
Historique:
received: 04 06 2023
accepted: 10 11 2023
medline: 15 1 2024
pubmed: 15 1 2024
entrez: 15 1 2024
Statut: ppublish

Résumé

Epicardial adipose tissue (EAT) contributes to inflammation and fibrosis of the neighboring myocardial tissue via paracrine signaling. In this retrospective study, we investigated the abnormal changes in the amount of EAT in male children with Duchenne muscular dystrophy (DMD) using cardiac magnetic resonance (CMR) imaging. Furthermore, we constructed and validated a nomogram including EAT-related CMR imaging parameter for predicting the occurrence of myocardial fibrosis in patients with DMD. This study enrolled 283 patients with DMD and 57 healthy participants who underwent CMR acquisitions to measure the quantitative parameters of EAT, pericardial adipose tissue (PAT), paracardial adipose tissue, and subcutaneous adipose tissue. Late gadolinium enhancement (LGE) was performed to confirm myocardial fibrosis in patients with DMD. The DMD group consisted of 200 patients from institution 1 (the ratio of the training set and the internal validation set was 7:3) and 83 patients from four other institutions (the external validation set). Logistic and least absolute shrinkage and selection operator (LASSO) regression was used to select the optimal predictors and to develop and validate the nomogram model predicting LGE risk in the training set, internal validation set, and external validation set. Compared with those in healthy controls, some regional EAT thicknesses, areas, and global volumes were significantly higher in patients with DMD, and 41.7% of patients with DMD showed positive LGE. These LGE-positive patients with DMD showed significantly higher EAT volume (median 23.9 mL/m The onset of LGE-based myocardial fibrosis was associated with EAT volume in patients with DMD. Additionally, the nomogram with EAT volumes showed superior performance in patients with DMD for predicting the occurrence of myocardial fibrosis.

Sections du résumé

Background UNASSIGNED
Epicardial adipose tissue (EAT) contributes to inflammation and fibrosis of the neighboring myocardial tissue via paracrine signaling. In this retrospective study, we investigated the abnormal changes in the amount of EAT in male children with Duchenne muscular dystrophy (DMD) using cardiac magnetic resonance (CMR) imaging. Furthermore, we constructed and validated a nomogram including EAT-related CMR imaging parameter for predicting the occurrence of myocardial fibrosis in patients with DMD.
Methods UNASSIGNED
This study enrolled 283 patients with DMD and 57 healthy participants who underwent CMR acquisitions to measure the quantitative parameters of EAT, pericardial adipose tissue (PAT), paracardial adipose tissue, and subcutaneous adipose tissue. Late gadolinium enhancement (LGE) was performed to confirm myocardial fibrosis in patients with DMD. The DMD group consisted of 200 patients from institution 1 (the ratio of the training set and the internal validation set was 7:3) and 83 patients from four other institutions (the external validation set). Logistic and least absolute shrinkage and selection operator (LASSO) regression was used to select the optimal predictors and to develop and validate the nomogram model predicting LGE risk in the training set, internal validation set, and external validation set.
Results UNASSIGNED
Compared with those in healthy controls, some regional EAT thicknesses, areas, and global volumes were significantly higher in patients with DMD, and 41.7% of patients with DMD showed positive LGE. These LGE-positive patients with DMD showed significantly higher EAT volume (median 23.9 mL/m
Conclusions UNASSIGNED
The onset of LGE-based myocardial fibrosis was associated with EAT volume in patients with DMD. Additionally, the nomogram with EAT volumes showed superior performance in patients with DMD for predicting the occurrence of myocardial fibrosis.

Identifiants

DOI: 10.21037/qims-23-790 PMID: 38223028 PMC: PMC10784074
pubmed: 38223028
doi: 10.21037/qims-23-790
pii: qims-14-01-736
pmc: PMC10784074
doi:

Types de publication

Journal Article

Langues

eng

Pagination

736-748

Informations de copyright

2024 Quantitative Imaging in Medicine and Surgery. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-790/coif). X.Z. is an employee of Siemens Healthineers Digital Technology (Shanghai) Co., Ltd., Shanghai, China. X.B. is an employee of Siemens Medical Solutions USA, Inc., Los Angeles, CA, USA. The other authors have no conflicts of interest to declare.

Auteurs

Weifeng Yuan (W)

Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
Department of Medical Imaging, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu, China.

Huayan Xu (H)

Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.

Li Yu (L)

Department of Pediatric Cardiovascular Medicine, West China Second University Hospital, Sichuan University, Chengdu, China.

Lingyi Wen (L)

Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.

Ke Xu (K)

Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.

Linjun Xie (L)

Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.

Rong Xu (R)

Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.

Hang Fu (H)

Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.

Bentian Liu (B)

Department of Medical Imaging, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu, China.

Ting Xu (T)

Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.

Xiaoyue Zhou (X)

Siemens Healthineers Digital Technology (Shanghai) Co., Ltd., Shanghai, China.

Xiaoming Bi (X)

Siemens Medical Solutions USA, Inc., Los Angeles, CA, USA.

Xiaotang Cai (X)

Department of Rehabilitation, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.

Yingkun Guo (Y)

Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.

Classifications MeSH