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AI Improves Prediction of Sudden Cardiac Death Using MRI Scans

By MedImaging International staff writers
Posted on 18 Jul 2023

Image: Integrating data from magnetic resonance imaging can add prognostic value to risk models (Photo courtesy of Freepik)

Hypertrophic cardiomyopathy (HCM) is a genetic condition that causes the heart muscle to thicken abnormally, impacting its ability to effectively pump oxygenated blood throughout the body. HCM, while often asymptomatic, can lead to shortness of breath, arrhythmia, and sudden cardiac death. Typically, patients diagnosed with this condition are monitored for the presence of cardiac scar tissue, a significant risk factor for sudden cardiac death, using magnetic resonance imaging (MRI). A relatively new AI technology, radiomics, offers a quantitative approach to medical imaging, extracting more data from medical images to better understand diseases and predict patient outcomes. Now, a new study has found that radiomic data drawn from the MRI scans of HCM patients may aid in predicting arrhythmic events and potential sudden death.

The team of physician-researchers at Beth Israel Deaconess Medical Center (BIDMC, Boston, MA, USA) and Lahey Hospital & Medical Center (LHMC, Burlington, MA, USA) analyzed cardiac imaging data from 1,229 HCM patients treated at academic medical centers in Boston, Toronto, and Florence from 2003 to 2018. Each patient's risk of sudden cardiac death within five years was calculated using two existing risk score models that rely on clinical and imaging variables, including age, family history of sudden cardiac death, thickness of the heart wall, and scar tissue burden. Subsequently, the researchers used the patients' MRIs to generate scar tissue maps, extracting an extensive set of radiomic features, including 14 shape parameters and 930 texture features, resulting in 1,888 radiomic features representing the shape and texture of each patient's scar tissue map. These data were then used to develop new mathematical models for predicting sudden cardiac death probability.

Upon examining the patients' outcomes, the researchers found that 30 patients (2.4%) experienced a sudden cardiac death event within a follow-up period of up to 6.5 years. Incorporating radiomic features with clinical risk assessment scores significantly improved risk prediction, with one model correctly identifying 19 of the patients who experienced a sudden cardiac death event as high-risk. Furthermore, the analysis identified a significant prognostic radiomic feature for predicting sudden cardiac death risk - a texture feature of the scar tissue map. While further research is required, this discovery illustrates how radiomics can potentially reveal new biomarkers useful for monitoring patients with HCM and other conditions with minimal clinical signs and symptoms.

“Advances in imaging technologies and image analysis tools have allowed the investigation of novel features to predict the risk of sudden cardiac death in patients with HCM,” said Martin Maron, MD, Director of the Hypertrophic Cardiomyopathy Center at LHMC. “Our proof-of-concept study showed that radiomics analysis can add incremental prognostic value to current established risk prediction models, potentially saving lives.”

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63 (54.121017456055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

64 (79.870223999023): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

65 (483.98971557617): SELECT fid FROM jos_deeppockets WHERE id=294797924 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294797924 AND published='1' LIMIT 1

66 (293.97010803223): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

67 (43.869018554688): select jos_twitters.link from jos_twitters where cat=10

68 (28.848648071289): select jos_facebook.link from jos_facebook where cat=10

69 (30.040740966797): select jos_google_plus.link from jos_google_plus where cat=10

70 (28.848648071289): select jos_linkedin.link from jos_linkedin where cat=10

71 (46.014785766602): SELECT fid FROM jos_deeppockets WHERE id=294797924 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294797924 AND published='1' LIMIT 1

72 (41.961669921875): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

73 (244.8558807373): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294797924 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (209.09309387207): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294797924 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (37.908554077148): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

76 (54.836273193359): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (45.061111450195): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294797924 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (28.848648071289): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294797924 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (41.961669921875): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

93 (47.206878662109): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

108 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

109 (50.067901611328): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294797924 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (46.014785766602): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294797924 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

112 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

113 (66.995620727539): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294797924 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (497.81799316406): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294797924 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (670.9098815918): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

116 (415.08674621582): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

117 (102.99682617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

118 (84.161758422852): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

119 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

120 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

121 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

122 (38.14697265625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

123 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

124 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

125 (295.87745666504): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

126 (!!!!! 27801.990509033): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

127 (505.92422485352): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294797924 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294797924 AND type='deeppockets_item' AND published='1' LIMIT 1

128 (52.928924560547): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

129 (35.04753112793): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

130 (41.961669921875): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

131 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

132 (39.100646972656): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

133 (28.133392333984): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

134 (27.894973754883): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

135 (30.994415283203): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

136 (27.894973754883): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

137 (27.894973754883): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

138 (541.92543029785): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (391.00646972656): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (241.99485778809): SELECT name FROM jos_deeppockets WHERE id=212

141 (34.093856811523): SELECT name FROM jos_deeppockets WHERE id=212

142 (575.06561279297): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

143 (458.0020904541): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

144 (100.85105895996): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

145 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

146 (!!!!! 8754.0149688721): TRUNCATE TABLE jos_trademed_module

147 (109.91096496582): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294797924 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (53.882598876953): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294797924 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

149 (843.04809570312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

151 (53.882598876953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

152 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

153 (!!!!! 1163.9595031738): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

154 (74.148178100586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

155 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

156 (45.061111450195): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294797924 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294797924 AND type='deeppockets_item' AND published='1' LIMIT 1

157 (51.975250244141): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

158 (41.007995605469): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

159 (38.14697265625): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

160 (88.930130004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

161 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797924 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797924 AND published='1' LIMIT 1

162 (51.021575927734): select jos_twitters.link from jos_twitters where cat=10

163 (32.186508178711): select jos_facebook.link from jos_facebook where cat=10

164 (31.948089599609): select jos_google_plus.link from jos_google_plus where cat=10

165 (31.232833862305): select jos_linkedin.link from jos_linkedin where cat=10

166 (301.12266540527): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

167 (!!!!! 1196.8612670898): insert into jos_banners_delta values (14615,'2025-08-03 09:16:49','216.73.216.210','view'),(14202,'2025-08-03 09:16:49','216.73.216.210','view'),(14203,'2025-08-03 09:16:49','216.73.216.210','view')

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