Exploring the EVolution in PrognOstic CapabiLity of MUltisequence Cardiac MagneTIc ResOnance in PatieNts Affected by Takotsubo Cardiomyopathy Based on Machine Learning Analysis

Author:

Cau Riccardo1ORCID,Muscogiuri Giuseppe23,Pisu Francesco1,Gatti Marco4,Velthuis Birgitta5,Loewe Christian6,Cademartiri Filippo7,Pontone Gianluca8,Montisci Roberta9,Guglielmo Marco10,Sironi Sandro211,Esposito Antonio1213,Francone Marco14,Dacher Nicholas15,Peebles Charles16,Bastarrika Gorka17,Salgado Rodrigo18,Saba Luca1

Affiliation:

1. Radiology

2. School of Medicine and Surgery, University of Milano-Bicocca

3. Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital

4. Department of Radiology, Università degli studi di Torino, Turin

5. University Medical Center Utrecht

6. Medizinische Universität Wien, Vienna, Austria

7. IRCCS SDN, Naples

8. IRCCS Centro Cardiologico Monzino

9. Cardiology, Azienda Ospedaliero Universitaria, Monserrato (Cagliari)

10. Department of Cardiology, Universitair Medisch Centrum, Utrecht, The Netherlands

11. Department of Radiology, ASST Papa Giovanni XXIII Hospital, Bergamo

12. Experimental Imaging Center, IRCCS San Raffaele Scientific Institute

13. School of Medicine, Vita Salute San Raffaele University, Milan

14. Humanitas University, Pieve Emanuele, Italy

15. Cardiac MR/CT Unit, Department of Radiology, Rouen University Hospital, Rouen, France

16. University Hospital Southampton NHS Foundation Trust, Southampton, UK

17. Department of Radiology, Clinica Universidad de Navarra, Pamplona, Spain

18. Universitair Ziekenhuis Antwerpen, Edegem, Belgium

Abstract

Purpose: Takotsubo cardiomyopathy (TTC) is a transient but severe acute myocardial dysfunction with a wide range of outcomes from favorable to life-threatening. The current risk stratification scores of TTC patients do not include cardiac magnetic resonance (CMR) parameters. To date, it is still unknown whether and how clinical, trans-thoracic echocardiography (TTE), and CMR data can be integrated to improve risk stratification. Methods: EVOLUTION (Exploring the eVolution in prognOstic capabiLity of mUlti-sequence cardiac magneTIc resOnance in patieNts affected by Takotsubo cardiomyopathy) is a multicenter, international registry of TTC patients who will undergo a clinical, TTE, and CMR evaluation. Clinical data including demographics, risk factors, comorbidities, laboratory values, ECG, and results from TTE and CMR analysis will be collected, and each patient will be followed-up for in-hospital and long-term outcomes. Clinical outcome measures during hospitalization will include cardiovascular death, pulmonary edema, arrhythmias, stroke, or transient ischemic attack. Clinical long-term outcome measures will include cardiovascular death, pulmonary edema, heart failure, arrhythmias, sudden cardiac death, and major adverse cardiac and cerebrovascular events defined as a composite endpoint of death from any cause, myocardial infarction, recurrence of TTC, transient ischemic attack, and stroke. We will develop a comprehensive clinical and imaging score that predicts TTC outcomes and test the value of machine learning models, incorporating clinical and imaging parameters to predict prognosis. Conclusions: The main goal of the study is to develop a comprehensive clinical and imaging score, that includes TTE and CMR data, in a large cohort of TTC patients for risk stratification and outcome prediction as a basis for possible changes in patient management.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Pulmonary and Respiratory Medicine,Radiology, Nuclear Medicine and imaging

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