Cardiac magnetic resonance radiomics reveal differential impact of sex, age, and vascular risk factors on cardiac structure and myocardial tissue
Cardiac magnetic resonance radiomics reveal differential impact of sex, age, and vascular risk factors on cardiac structure and myocardial tissue
Background: cardiovascular magnetic resonance (CMR) radiomics analysis provides multiple quantifiers of ventricular shape and myocardial texture, which may be used for detailed cardiovascular phenotyping.
Objectives: we studied variation in CMR radiomics phenotypes by age and sex in healthy UK Biobank participants. Then, we examined independent associations of classical vascular risk factors (VRFs: smoking, diabetes, hypertension, high cholesterol) with CMR radiomics features, considering potential sex and age differential relationships.
Design: image acquisition was with 1.5 Tesla scanners (MAGNETOM Aera, Siemens). Three regions of interest were segmented from short axis stack images using an automated pipeline: right ventricle, left ventricle, myocardium. We extracted 237 radiomics features from each study using Pyradiomics. In a healthy subset of participants (n = 14,902) without cardiovascular disease or VRFs, we estimated independent associations of age and sex with each radiomics feature using linear regression models adjusted for body size. We then created a sample comprising individuals with at least one VRF matched to an equal number of healthy participants (n = 27,400). We linearly modelled each radiomics feature against age, sex, body size, and all the VRFs. Bonferroni adjustment for multiple testing was applied to all p-values. To aid interpretation, we organised the results into six feature clusters.
Results: amongst the healthy subset, men had larger ventricles with dimmer and less texturally complex myocardium than women. Increasing age was associated with smaller ventricles and greater variation in myocardial intensities. Broadly, all the VRFs were associated with dimmer, less varied signal intensities, greater uniformity of local intensity levels, and greater relative presence of low signal intensity areas within the myocardium. Diabetes and high cholesterol were also associated with smaller ventricular size, this association was of greater magnitude in men than women. The pattern of alteration of radiomics features with the VRFs was broadly consistent in men and women. However, the associations between intensity based radiomics features with both diabetes and hypertension were more prominent in women than men.
Conclusions: we demonstrate novel independent associations of sex, age, and major VRFs with CMR radiomics phenotypes. Further studies into the nature and clinical significance of these phenotypes are needed.
763361
Raisi-Estabragh, Zahra
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Jaggi, Akshay
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Gkontra, Polyxeni
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McCracken, Celeste
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Aung, Nay
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Munroe, Patricia B
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Neubauer, Stefan
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Harvey, Nicholas C
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Lekadir, Karim
b8de558a-869c-4574-b0d3-005dc52c3106
Petersen, Steffen E
04f2ce88-790d-48dc-baac-cbe0946dd928
22 December 2021
Raisi-Estabragh, Zahra
43c85c5e-4574-476b-80d6-8fb1cdb3df0a
Jaggi, Akshay
3c44b68c-526b-43d4-932e-8dac54a91fa8
Gkontra, Polyxeni
bf8e2eda-7fb2-4de0-b884-edd345e2712d
McCracken, Celeste
5d772e9e-3aaa-41da-a5ef-3943b1631fd9
Aung, Nay
709b152d-e704-4fdc-b066-7eafaa643a0b
Munroe, Patricia B
44d23746-20cd-4572-860e-7350424cc031
Neubauer, Stefan
c8a34156-a4ed-4dfe-97cb-4f47627d927d
Harvey, Nicholas C
ce487fb4-d360-4aac-9d17-9466d6cba145
Lekadir, Karim
b8de558a-869c-4574-b0d3-005dc52c3106
Petersen, Steffen E
04f2ce88-790d-48dc-baac-cbe0946dd928
Raisi-Estabragh, Zahra, Jaggi, Akshay, Gkontra, Polyxeni, McCracken, Celeste, Aung, Nay, Munroe, Patricia B, Neubauer, Stefan, Harvey, Nicholas C, Lekadir, Karim and Petersen, Steffen E
(2021)
Cardiac magnetic resonance radiomics reveal differential impact of sex, age, and vascular risk factors on cardiac structure and myocardial tissue.
Frontiers in Cardiovascular Medicine, 8, .
(doi:10.3389/fcvm.2021.763361).
Abstract
Background: cardiovascular magnetic resonance (CMR) radiomics analysis provides multiple quantifiers of ventricular shape and myocardial texture, which may be used for detailed cardiovascular phenotyping.
Objectives: we studied variation in CMR radiomics phenotypes by age and sex in healthy UK Biobank participants. Then, we examined independent associations of classical vascular risk factors (VRFs: smoking, diabetes, hypertension, high cholesterol) with CMR radiomics features, considering potential sex and age differential relationships.
Design: image acquisition was with 1.5 Tesla scanners (MAGNETOM Aera, Siemens). Three regions of interest were segmented from short axis stack images using an automated pipeline: right ventricle, left ventricle, myocardium. We extracted 237 radiomics features from each study using Pyradiomics. In a healthy subset of participants (n = 14,902) without cardiovascular disease or VRFs, we estimated independent associations of age and sex with each radiomics feature using linear regression models adjusted for body size. We then created a sample comprising individuals with at least one VRF matched to an equal number of healthy participants (n = 27,400). We linearly modelled each radiomics feature against age, sex, body size, and all the VRFs. Bonferroni adjustment for multiple testing was applied to all p-values. To aid interpretation, we organised the results into six feature clusters.
Results: amongst the healthy subset, men had larger ventricles with dimmer and less texturally complex myocardium than women. Increasing age was associated with smaller ventricles and greater variation in myocardial intensities. Broadly, all the VRFs were associated with dimmer, less varied signal intensities, greater uniformity of local intensity levels, and greater relative presence of low signal intensity areas within the myocardium. Diabetes and high cholesterol were also associated with smaller ventricular size, this association was of greater magnitude in men than women. The pattern of alteration of radiomics features with the VRFs was broadly consistent in men and women. However, the associations between intensity based radiomics features with both diabetes and hypertension were more prominent in women than men.
Conclusions: we demonstrate novel independent associations of sex, age, and major VRFs with CMR radiomics phenotypes. Further studies into the nature and clinical significance of these phenotypes are needed.
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fcvm-08-763361
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Accepted/In Press date: 30 November 2021
Published date: 22 December 2021
Additional Information:
This project was enabled through access to the MRC eMedLab
Medical Bioinformatics infrastructure, supported by the Medical
Research Council (www.mrc.ac.uk; MR/L016311/1). PM and
SP acknowledge support from the National Institute for
Frontiers in Cardiovascular Medicine | www.frontiersin.org 13 December 2021 | Volume 8 | Article 763361
Raisi-Estabragh et al. Vascular Risk Factors Radiomics Phenotypes
Health Research (NIHR) Barts Biomedical Research Centre. SP
acknowledges support from the SmartHeart EPSRC programme
grant (www.nihr.ac.uk; EP/P001009/1) and from the CAP-AI
programme, Londons first AI enabling programme focused
on stimulating growth in the capital’s AI Sector. CAP-AI is
led by Capital Enterprise in partnership with Barts Health
NHS Trust and Digital Catapult and was funded by the
European Regional Development Fund and Barts Charity.
SP acts as a paid consultant to and is a shareholder of Circle
Cardiovascular Imaging Inc., Calgary, Canada and Servier. SP
acknowledges the British Heart Foundation for funding the
manual analysis to create a cardiovascular magnetic resonance
imaging reference standard for the UK Biobank imaging
resource in 5000 CMR scans (www.bhf.org.uk; PG/14/89/31194).
PG, KL, and SP have received funding from the European
Union’s 2020 research and innovation programme under grant
agreement No 825903 (euCanSHare project). KL received
funding from the Spanish Ministry of Science, Innovation and
Universities under grant agreement RTI2018-099898-B-I00.
NH acknowledges support from UK Medical Research Council
(MC_UU_12011/1) and NIHR Southampton Biomedical
Research Centre, University of Southampton and University
Hospital Southampton. NA recognise the National Institute
for Health Research (NIHR) Integrated Academic Training
programme which supports his Academic Clinical Lectureship
posts. ZR-E was supported by British Heart Foundation
Clinical Research Training Fellowship No. FS/17/81/33318.
AJ was supported by a Fulbright Predoctoral Research
Award (2019-2020).
Identifiers
Local EPrints ID: 455189
URI: http://eprints.soton.ac.uk/id/eprint/455189
ISSN: 2297-055X
PURE UUID: 0562b7b5-e22a-41a5-80ad-f2262e2f9650
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Date deposited: 14 Mar 2022 17:52
Last modified: 17 Mar 2024 02:58
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Contributors
Author:
Zahra Raisi-Estabragh
Author:
Akshay Jaggi
Author:
Polyxeni Gkontra
Author:
Celeste McCracken
Author:
Nay Aung
Author:
Patricia B Munroe
Author:
Stefan Neubauer
Author:
Karim Lekadir
Author:
Steffen E Petersen
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