Evidence map›Paper›PMID 42447756›Full record

ArticleEBioMedicine2026

CardioMorph Atlas: a statistical approach to evaluate association between pulmonary tuberculosis and cardiac morphology from chest X-rays.

Amritpal Singh, Sena Azamat, Gourav Modanwal, Pushkar Mutha, Pingfu Fu, Neel R Gandhi, Rohan Dhamdhere, Mendel Lebowitz, Sadeer Al-Kindi, Anurag Aggarwal and 2 more

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Article in EBioMedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Amritpal SinghEmory University School of Medicine, Atlanta, USA; Department of Computer Science, Emory University, Atlanta, USA.
Sena AzamatEmory University School of Medicine, Atlanta, USA.
Gourav ModanwalDepartment of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.
Pushkar MuthaDepartment of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.
Pingfu FuDepartment of Population and Quantitative Health Sciences, Case Western Reserve University, USA.
Neel R GandhiDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA.
Rohan DhamdhereDepartment of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.
Mendel LebowitzDepartment of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.
Sadeer Al-KindiPreventive Cardiology, Houston Methodist, USA.
Anurag AggarwalBiosciences and Health Research, Ashoka University, India.
Yingda L XieDepartment of Medicine and the Public Health Research Institute, Rutgers New Jersey Medical School, USA.
Anant MadabhushiEmory University School of Medicine, Atlanta, USA; Department of Computer Science, Emory University, Atlanta, USA; Atlanta Veterans Administration Medical Center, Atlanta, USA. Electronic address: anantm@emory.edu.

Funding

BLRD VA IK6 BX006185
6 · The paper itself

Abstract

backgroundPatients with tuberculosis (TB) face an elevated risk of certain cardiovascular diseases. The inflammatory response associated with TB is linked to cardiac complications, though the spatial impact on cardiac structure remains understudied. In this study, we assess population-level differences in cardiac morphology in TB using an atlas-based approach applied to routine chest X-rays.

methodsA total of 8651 patients (with 2626 patients with TB) were selected from four cohorts: Shenzhen, TBX11K, TB Portals, and MIMIC, covering seven countries. We developed a representative cardiac template, CardioMorph Atlas, and compared population-level morphological differences between patients with TB and controls. Cardiac borders and areas were quantified into CardioMorph features and analysed for their association with all-cause mortality using Cox regression.

findingsCardioMorph Atlas revealed significant lateral elongation of the heart in patients with TB, in both left and right ventricles, with patterns distinct from those in pneumonia and cardiomegaly. Vector field analysis showed lateral extension of cardiac structures in patients with TB. Upper area (hazard ratio: 2.18, 95% CI: 1.1-4.30, p = 0.022) and right perimeter (HR = 2.07, 95% CI:1.06-4.02) were significantly associated with increased all-cause mortality in patients with TB. CardioMorph features showed strong associations with all-cause mortality in patients with TB, supporting their potential utility for risk stratification, and which demonstrates feasibility of quantitatively assessing impact of TB on cardiac morphology using routine chest X-rays.

interpretationThese findings suggest that tuberculosis is linked to distinct, prognostically relevant cardiac morphological alterations detectable on routine chest X-rays using the CardioMorph Atlas. Further prospective validation is warranted.

fundingNational Heart, Lung and Blood Institute; National Institute of Allergy and Infectious Diseases.

Indexed as

HeartRadiography, ThoracicTuberculosis, PulmonaryAdultAgedFemaleHumansMaleMiddle AgedCardiac remodellingChest X-raysImaging biomarkersPulmonary tuberculosis

Identifiers

PMID42447756
PMCPMC13377491

What Socratic holds

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.