Assessment of Myocardial Microcirculation and Its Relationship with Cardiac Remodeling and Myocardial Fibrosis in Athletes Based on IVIM-DWI Images
Description
To assess myocardial microcirculation in athletes using intravoxel incoherent motion (IVIM) diffusion-weighted imaging and its relationship with cardiac remodeling (CR) and myocardial fibrosis (MF).Continuous 174 athletes and 54 healthy sedentary controls were prospectively recruited for cardiac magnetic resonance imaging (CMRI). Bi-ventricular function and IVIM parameters of 16 myocardial segments for left ventricle were measured and compared between different groups. Subsequently, machine learning models were utilized to predict CR and/or MF based on numerous clinical data and these IVIM parameters. The fast apparent diffusion coefficient (ADCfast) and perfusion fraction (f) of 16 myocardial segments and each blood supply area in athletes were significantly lower than in controls (p < 0.05). There were statistical differences for IVIM parameters among different exercise types (p<0.05). The myocardial slow apparent diffusion coefficient (ADCslow) values of athletes with CR and/or MF were lower than the remaining athletes (p < 0.05).The IVIM value were related with CMRI first-pass perfusion parameters and the presence of myocardial delayed enhancement (p < 0.05). Gradient boosting machine (GBM) was the best model to predict CR and/or MF based on these hypo-perfusion parameters, with an accuracy of 78.7%, area under the receiver operating characteristic curve of 0.865, sensitivity of 82.8%, and specificity of 77.9%. The ADCslow value of the 5th segment was the most important predictor for CR and/or MF.