The Clinical Value Of Left Ventricular Shape Index And Eccentricity Index In Evaluating Left Ventricular Remodeling

Objective:Left ventricular remodeling(LVR)plays a decisive role in the development of heart failure(HF),and changes in left ventricular morphology often indicate poor prognosis.The purpose of this study was to investigate the clinical value of left ventricular shape index(SI)and eccentricity index(EI)obtained by gated myocardial perfusion imaging(GMPI)in evaluating left ventricular morphology,predicting left ventricular remodeling and left ventricular systolic function impairment.Methods:This study included 324 patients with myocardial infarction and 113 healthy controls.End-diastolic shape index(EDSI),end-systolic shape index(ESSI),EI and left ventricular function parameters were obtained by quantitative gated SPECT(QGS)software.End-diastolic volume(EDV),end-systolic volume(ESV),left ventricular ejection fraction(LVEF),summed motion score(SMS),summed thickening score(STS)and peak ejection rate(PER)were obtained,peak filling rate(PFR).Propensity score(PS)inverse probability of treatment weighting(IPTW)was used to balance the intergroup covariates.The differences and correlations of EDSI,ESSI,EI and left ventricular function parameters between the two groups were analyzed.Receiver operating characteristic(ROC)area under curve(AUC)was used to evaluate the value of EDV combined with EDSI,ESSI and EI in assessing impaired left ventricular systolic function.PS was calculated by R software.After IPTW,the absolute standardized mean differences(ASMD)≤0.2 was taken as the equilibrium test index.SPSS26.0 was used for statistical analysis.The t test and Pearson correlation were used to analyze the measurement data that followed or approximately followed the normal distribution.Mann-Whitney U test and Spearman correlation were used to analyze the measurement data that did not conform to normal distribution or skewed distribution.The chi-square test was used to analyze the counting data.Results:1.The increase of EDSI and ESSI and the decrease of EI indicate the increase of left ventricular sphericity and the aggravation of left ventricular remodeling.The unequally distributed covariates between the two groups reached equilibrium after IPTW.After IPTW,EDSI and ESSI in myocardial infarction group were higher than those in healthy control group(t:-8.049,-14.669,P<0.001),while EI in myocardial infarction group was lower than that in healthy control group(t=8.934,P<0.001).2.There is a strong positive correlation between EDSI and ESSI in both groups(r=0.928 in myocardial infarction group and 0.873 in healthy control group,all P<0.01),and a strong negative correlation between EDSI,ESSI and EI(r=-0.831 and-0.812 in myocardial infarction group and-0.786 and-0.641 in healthy control group)EDSI and ESSI were negatively correlated with LVEF(r=-0.214 and-0.430 in myocardial infarction group and-0.346 and-0.625 in healthy control group,all P<0.01),while ESSI was positively correlated with EDV,ESV and SMS with moderate intensity(r=0.336 and 0.382 in myocardial infarction group)ESSI was negatively correlated with-PER and PFR with moderate intensity(r values:-0.384 and-0.352 in myocardial infarction group and-0.406 and-0.388in healthy control group,all P<0.01).3.ROC curve showed that EDV(AUC:0.895,95%CI 0.833-0.957)was superior to EDSI,ESSI and EI in evaluating left ventricular systolic dysfunction in myocardial infarction group.ESSI(AUC:0.839,95%CI 0.766-0.911)in healthy control group was more effective than EDV,EDSI and EI in evaluating left ventricular systolic dysfunction.The evaluation efficiency of EDV combined with EDSI,ESSI and EI on left ventricular systolic dysfunction(AUC:myocardial infarction group 0.956,healthy control group 0.911)was higher than that of EDV and EDV combined with EDSI or ESSI or EI alone.Conclusion:The increase of EDSI and ESSI and the decrease of EI indicate the increase of left ventricular sphericity and the aggravation of left ventricular remodeling.SI and EI have certain clinical application value in evaluating left ventricular morphology,predicting left ventricular remodeling and impaired left ventricular systolic function.