摘要
目的采用LASSO回归整合多种超声参数建立诊断模型,探讨其对心肌淀粉样变性(CA)与其他心肌肥厚疾病的鉴别诊断价值。资料与方法纳入11例CA左心室增厚、27例非CA左心室增厚以及22例心肌正常的受试者(对照组)。比较3组间左心室舒张末期内径、左心室收缩末期内径、左心房前后径、左心室射血分数(LVEF)、左心室室壁厚度、E/e’、E/A等超声参数的差异。通过LASSO回归建立积分模型,采用受试者工作特征(ROC)曲线评价其对CA和非CA左心室增厚的鉴别诊断效能。结果与非CA左心室增厚组及对照组比较,CA左心室增厚组的左心室舒张末期内径较小[(39±3)mm比(44±6)mm、(46±4)mm],LVEF较低[56.0%(50.5%,65.2%)比65.6%(61.6%,74.7%)、68.8%(64.2%,72.8%)],E/e'较高[18.9(15.0,27.2)比13.3(9.1,17.2)、9.4(8.4,11.5)],差异均有统计学意义(P均<0.05)。将上述常规超声心动图参数纳入LASSO回归建立积分模型,鉴别CA左心室增厚和非CA左心室增厚的ROC曲线下面积为1.000(95%CI 1.000~1.000),最佳阈值为-0.702,特异度、敏感度均为100%。结论通过LASSO回归建立的超声积分模型可鉴别CA与非CA左心室肥厚。
Purpose To differentiate cardiac amyloidosis(CA)and other myocardial hypertrophy diseases by using echocardiography diagnostic model established by LASSO regression.Materials and Methods Eleven CA with left ventricular hypertrophy(LVH),27 non-CA with LVH and 22 control subjects were enrolled.Echocardiographic parameters including left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left atrial diameter(LAD),left ventricular ejection fraction(LVEF),left ventricular posterior wall thickness(LVPWT),left ventricular septal thickness,E/e′and E/A,were compared among three groups.The echocardiography integral model was established by LASSO regression and receiver operating characteristic(ROC)curve was used to distinguish CA with LVH group from the non-CA with LVH group.Results Compared with non-CA with LVH group and control group,CA with LVH showed lower LVEDD[(39±3)mm vs.(44±6)mm,(46±4)mm],lower LVEF[56.0%(50.5%,65.2%)vs.65.6%(61.6%,74.7%),68.8%(64.2%,72.8%)],and higher E/e'[18.9(15.0,27.2)vs.13.3(9.1,17.2),9.4(8.4,11.5),P<0.05].All of above parameters were included in the LASSO regression to establish an integral model.ROC analysis revealed that the sensitivity and specificity of the model for predicting CA were both 100%,AUC was 1.000[95%CI(1.000,1.000)],the optimal cut-off value was-0.702.Conclusion The echocardiography integral model established by LASSO regression can differentiate CA with LVH from non-CA with LVH.
作者
杨帆
黄竞舟
王智
范芳芳
龚艳君
洪涛
YANG Fan;HUANG Jingzhou;WANG Zhi;FAN Fangfang;GONG Yanjun;HONG Tao(Department of Cardiology,Peking University First Hospital,Beijing 100034,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2021年第2期136-141,共6页
Chinese Journal of Medical Imaging
