Apical conicity ratio: A new index on left ventricular apical geometry after myocardial infarction Hongguang Fan, MD, Zhe Zheng, MD, Wei Feng, MD, Yan.

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Presentation transcript:

Apical conicity ratio: A new index on left ventricular apical geometry after myocardial infarction Hongguang Fan, MD, Zhe Zheng, MD, Wei Feng, MD, Yan Zhang, MD, Lixin Jin, MD, PhD, Peng Li, MD, Shengshou Hu, MD, FACC The Journal of Thoracic and Cardiovascular Surgery Volume 140, Issue 6, Pages 1402-1407.e3 (December 2010) DOI: 10.1016/j.jtcvs.2010.02.017 Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 The magnetic resonance images and schematic diagrams depicted the 2-chamber view used to measure the areas of apical area and apical triangle in a patient (image A and B, ACR = 2.05) and a healthy (image A′ and B′, ACR = 1.24). Long-axis length was measured in 2-chamber view from the apex to the midpoint of the mitral valve and short-axis length was measured as the axis that perpendicularly intersects the midpoint of the long axis. The apical area was defined as the area of blood pool from the short axis to apex and its value was measured automatically by tracing of endocardial contour through an interactive interface (A, A′). The apical triangle area was calculated by the length of long axis and short axis (B, B′). ACR was the ratio of the area of apex over the area of apical triangle. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 1402-1407.e3DOI: (10.1016/j.jtcvs.2010.02.017) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Shape indices in healthy controls and patients. SId, diastolic sphericity index; SIs, systolic sphericity index; vSId, diastolic volumetric sphericity index; vSIs, systolic volumetric sphericity index; EId, diastolic eccentricity index; EIs, systolic eccentricity index; ACRd, diastolic apical conicity ratio; ACRs, systolic apical conicity ratio; DCM, dilated cardiomyopathy; LVA, left ventricular aneurysm. ∗Versus healthy, P < .01; #versus DCM, P < .01. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 1402-1407.e3DOI: (10.1016/j.jtcvs.2010.02.017) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Comparison of indices in health control and patients with left ventricular aneurysm preoperatively and postoperatively (n = 24). SI, Sphericity index; vSI, systolic volumetric sphericity index; EI, eccentricity index; ACR, apical conicity ratio. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 1402-1407.e3DOI: (10.1016/j.jtcvs.2010.02.017) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Apex of left ventricle and circular cone Apex of left ventricle and circular cone. A, Normal apex of left ventricle. B, A regular circular cone with the height (h) equal to that of apex. C, View of cross section of apex of left ventricle in 2-dimension image. D, View of cross section of circular cone with the height equal to that of apex in 2-dimension image. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 1402-1407.e3DOI: (10.1016/j.jtcvs.2010.02.017) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Correlations between ACR and scar score Correlations between ACR and scar score. ACRd and ACRs, Diastolic and systolic apical conicity ratio. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 1402-1407.e3DOI: (10.1016/j.jtcvs.2010.02.017) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Receiver operating characteristic curves for discrimination between LVA and non-LVA by systolic and diastolic sphericity index (SIs and SId), systolic and diastolic volumetric sphericity index (vSIs and vSId), systolic and diastolic eccentricity index (EIs and EId), and systolic and diastolic apical conicity ratio (ACRs and ACRd). LVA, Left ventricular aneurysm. A, Based on the measurements of diastolic images. B, Based on the measurements of systolic images. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 1402-1407.e3DOI: (10.1016/j.jtcvs.2010.02.017) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions