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Left ventricular outflow tract obstruction (LVOTO) is common in hypertrophic cardiomyopathy (HCM), but relationships between anatomical metrics and obstruction are poorly understood. We aimed to develop machine learning methods to evaluate LVOTO in HCM patients and quantify relationships between anatomical metrics and obstruction. This retrospective analysis of 1905 participants of the HCM Registry quantified 11 anatomical metrics derived from 14 landmarks automatically detected on the three-chamber long axis cine CMR images. Linear and logistic regression was used to quantify strengths of relationships with the presence of LVOTO (defined by resting Doppler pressure drop of > 30 mmHg), using the area under the receiver operating characteristic (AUC). Intraclass correlation coefficients between the network predictions and three independent observers showed similar agreement to that between observers. The distance from anterior mitral valve leaflet tip to basal septum (AML-BS) was most highly correlated with Doppler pressure drop (R2 = 0.19, p -5). Multivariate stepwise regression found the best predictive model included AML-BS, AML length to aortic valve diameter ratio, AML length to LV width ratio, and midventricular septal thickness metrics (AUC 0.84). Excluding AML-BS, metrics grouped according to septal hypertrophy, LV geometry, and AML anatomy each had similar associations with LVOTO (AUC 0.71, 0.71, 0.68 respectively, p = ns), significantly less than their combination (AUC 0.77, p 

Original publication

DOI

10.1007/s10554-022-02724-7

Type

Journal article

Journal

The international journal of cardiovascular imaging

Publication Date

12/2022

Volume

38

Pages

2695 - 2705

Addresses

Department of Biomedical Engineering, King's College London, 1 Lambeth Palace Rd, London, SE1 7EU, UK.

Keywords

HCMR investigators, Humans, Cardiomyopathy, Hypertrophic, Ventricular Outflow Obstruction, Magnetic Resonance Spectroscopy, Retrospective Studies, Predictive Value of Tests, Machine Learning