Journal article
Establishing T1 and ECV mapping based nomogram differentiate acute ischemic and nonischemic myocardial injury: a proof-of-concept study
BMC medical imaging, Vol.26(1), 104
2026
DOI: 10.1186/s12880-026-02176-8
PMID: 41606518
Abstract
To develop and validate a nomogram based on T1 and extracellular volume fraction (ECV) mapping derived from cardiovascular magnetic resonance (CMR) for differentiating ischemic from nonischemic cardiomyopathies during the acute phase.
This retrospective study included patients who underwent CMR at the Fifth Affiliated Hospital of Wenzhou Medical University (internal dataset) and the Fifth Affiliated Hospital of Sun Yat-sen University (external dataset). Patients were assigned to a training set (n = 73), a test set (n = 30), an internal validation set (n = 28), and an external validation set (n = 16). Six multivariable logistic regression models were constructed to predict acute nonischemic myocardial injury (NMI), and the best-performing model was selected to create an interactive online nomogram accessible via a dedicated webpage.
The optimal model incorporated coronary stenosis, hypertension, ejection fraction (EF), myocardial salvage index (MSI), T1 native non-edema, and ECV edema. It demonstrated strong predictive performance in the training set (AUC 0.970, 95% CI 0.938-0.989), test set (AUC 0.902, 95% CI 0.789-0.954), internal validation set (AUC 0.839, 95% CI 0.668-0.907), and external validation set (AUC 0.767, 95% CI 0.520-0.936). The model also showed excellent calibration and potential clinical utility.
In acute myocardial injury, increased T1 native non-edema values and reduced ECV edema values are indicative of NMI. The proposed nomogram demonstrated good generalizability and robustness, particularly in complex clinical scenarios, and offers promising potential for clinical application.
Details
- Title: Subtitle
- Establishing T1 and ECV mapping based nomogram differentiate acute ischemic and nonischemic myocardial injury: a proof-of-concept study
- Creators
- Yanping Su - Lishui Central HospitalCunxue Pan - Fifth Affiliated Hospital of Sun Yat-sen UniversityHongfei Hu - Lishui Central HospitalDi Shen - Lishui UniversityRuolei Ye - Zhejiang Chinese Medical UniversityChenhui Zhou - Lishui UniversityMingzhen Chen - Lishui UniversityMinjiang Chen - Lishui UniversityJian Chen - Sun Yat-sen UniversityKan Liu - Washington University in St. LouisJiayi Shen - Lishui UniversityShuiwei Xia - Lishui UniversityMin Xu - Lishui UniversityLingchun Lv - Lishui UniversityChenying Lu - Lishui UniversityJiansong Ji - Lishui Central Hospital
- Resource Type
- Journal article
- Publication Details
- BMC medical imaging, Vol.26(1), 104
- DOI
- 10.1186/s12880-026-02176-8
- PMID
- 41606518
- NLM abbreviation
- BMC Med Imaging
- ISSN
- 1471-2342
- eISSN
- 1471-2342
- Publisher
- Springer Nature
- Grant note
- Zhejiang Medical and Health Science Project: 2024KY563 Natural Science Foundation of Zhejiang Province: LBZ24H100001 National Natural Science Foundation of China: 82202144 National Key Research and Development Program of China: 2024YFC2417600
This study was supported by Zhejiang Medical and Health Science Project (2024KY563), Natural Science Foundation of Zhejiang Province (LBZ24H100001), National Natural Science Foundation of China (No. 82202144) and National Key Research and Development Program of China (2024YFC2417600).
- Language
- English
- Electronic publication date
- 01/29/2026
- Date published
- 2026
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9985132182102771
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