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Identifying myocardial infarction using hierarchical template matching–based myocardial strain : algorithm development and usability study

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Bhalodiya, Jayendra Maganbhai, Palit, Arnab, Giblin, Gerard, Tiwari, Manoj Kumar, Prasad, Sanjay K., Bhudia, Sunil K., Arvanitis, Theodoros N. and Williams, M. A. (2021) Identifying myocardial infarction using hierarchical template matching–based myocardial strain : algorithm development and usability study. JMIR Medical Informatics, 9 (2). e22164. doi:10.2196/22164 ISSN 2291-9694.

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Official URL: http://dx.doi.org/10.2196/22164

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Abstract

Background:
Myocardial infarction (MI; location and extent of infarction) can be determined by late enhancement cardiac magnetic resonance (CMR) imaging, which requires the injection of a potentially harmful gadolinium-based contrast agent (GBCA). Alternatively, emerging research in the area of myocardial strain has shown potential to identify MI using strain values.

Objective:
This study aims to identify the location of MI by developing an applied algorithmic method of circumferential strain (CS) values, which are derived through a novel hierarchical template matching (HTM) method.

Methods:
HTM-based CS H-spread from end-diastole to end-systole was used to develop an applied method. Grid-tagging magnetic resonance imaging was used to calculate strain values in the left ventricular (LV) myocardium, followed by the 16-segment American Heart Association model. The data set was used with k-fold cross-validation to estimate the percentage reduction of H-spread among infarcted and noninfarcted LV segments. A total of 43 participants (38 MI and 5 healthy) who underwent CMR imaging were retrospectively selected. Infarcted segments detected by using this method were validated by comparison with late enhancement CMR, and the diagnostic performance of the applied algorithmic method was evaluated with a receiver operating characteristic curve test.

Results:
The H-spread of the CS was reduced in infarcted segments compared with noninfarcted segments of the LV. The reductions were 30% in basal segments, 30% in midventricular segments, and 20% in apical LV segments. The diagnostic accuracy of detection, using the reported method, was represented by area under the curve values, which were 0.85, 0.82, and 0.87 for basal, midventricular, and apical slices, respectively, demonstrating good agreement with the late-gadolinium enhancement–based detections.

Conclusions:
The proposed applied algorithmic method has the potential to accurately identify the location of infarcted LV segments without the administration of late-gadolinium enhancement. Such an approach adds the potential to safely identify MI, potentially reduce patient scanning time, and extend the utility of CMR in patients who are contraindicated for the use of GBCA.

Item Type: Journal Article
Subjects: Q Science > QA Mathematics > QA76 Electronic computers. Computer science. Computer software
R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Engineering > WMG (Formerly the Warwick Manufacturing Group)
Library of Congress Subject Headings (LCSH): Myocardial infarction, Cardiovascular system -- Magnetic resonance imaging, Heart -- Left ventricle
Journal or Publication Title: JMIR Medical Informatics
Publisher: JMIR Publications
ISSN: 2291-9694
Official Date: 10 February 2021
Dates:
DateEvent
10 February 2021Published
7 November 2020Accepted
5 July 2020Submitted
Volume: 9
Number: 2
Article Number: e22164
DOI: 10.2196/22164
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 11 February 2021
Date of first compliant Open Access: 12 February 2021
Funder: Health Data Research (HDR) UK
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIED[MRC] Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
UNSPECIFIED[EPSRC] Engineering and Physical Sciences Research Councilhttp://dx.doi.org/10.13039/501100000266
UNSPECIFIED[ESRC] Economic and Social Research Councilhttp://dx.doi.org/10.13039/501100000269
UNSPECIFIEDDepartment of Health and Social CareUNSPECIFIED
UNSPECIFIEDChief Scientist Office, Scottish Government Health and Social Care Directoratehttp://dx.doi.org/10.13039/100014589
UNSPECIFIEDHealth and Social Care Research and Development Divisionhttp://dx.doi.org/10.13039/501100010756
UNSPECIFIEDPublic Health Agencyhttp://dx.doi.org/10.13039/501100001626
UNSPECIFIEDBritish Heart Foundationhttp://dx.doi.org/10.13039/501100000274
UNSPECIFIEDWellcome Trusthttp://dx.doi.org/10.13039/100010269
Is Part Of: 1
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