Diagnostic efficacy of complexity metrics from cardiac MRI myocardial segmental motion curves in detecting late gadolinium enhancement in myocardial infarction patients.

Background: Myocardial segmental motion is associated with cardiovascular pathology, often assessed through myocardial strain features. The stability of the motion can be influenced by myocardial fibrosis. This research aimed to explore the complexity metrics (CM) of myocardial segmental motion curves, observe their correlation with late gadolinium enhancement (LGE) transmural extension (TE), and assess diagnostic efficacy combined with segmental strains in different TE segments.

Methods: We included 42 myocardial infarction patients, dividing images into 672 myocardial segments (208 remote, 384 viable, and 80 unviable segments based on TE). Radial and circumferential segmental strain, along with CM for motion curves, were extracted. Correlation between CM and LGE, as well as the potential distinguishing role of CM, was evaluated using Pearson correlation, univariate linear regression (F-test), multivariate regression analysis (T-test), area under curve (AUC), machine learning models, and DeLong test.

Results: All CMs showed significant linear correlation with TE ( < 0.001). Six CMs were correlated with TE (r > 0.3), with radial frequency drift (FD) displayed the strongest correlation (r = 0.496,  < 0.001). Radial and circumferential FD significantly differed in higher TE myocardium than in remote segments ( < 0.05). Radial FD had practical diagnostic efficacy (remote vs. unviable AUC = 0.89, viable vs. unviable AUC = 0.77, remote vs. viable AUC = 0.65). Combining CM with segmental strain features boosted diagnostic efficacy than models using only segmental strain features (DeLong test,  < 0.05).

Conclusions: The CM of myocardial motion curves has been associated with LGE infarction, and combining CM with strain features improves the diagnosis of different myocardial LGE infarction degrees.