Cardiac magnetic resonance imaging (Cardiac MRI) has become a gold standard diagnostic technique for the assessment of cardiac mechanics, allowing the non-invasive calculation of left ventricular long axis longitudinal shortening (LVLS) and absolute myocardial torsion (AMT) between basal and apical left ventricular slices, a movement directly related to the helicoidal anatomic disposition of the myocardial fibers. The aim of this study is to determine AMT and LVLS behaviour and normal values from a group of healthy subjects. A group of 21 healthy volunteers (15 males) (age: 23-55 y.o., mean: 30.7 ± 7.5) were prospectively included in an observational study by cardiac MRI. Left ventricular rotation (degrees) was calculated by custom-made software (Harmonic Phase Flow) in consecutive LV short axis planes tagged cine-MRI sequences. AMT was determined from the difference between basal and apical planes LV rotations. LVLS (%) was determined from the LV longitudinal and horizontal axis cine-MRI images. All the 21 cases studied were interpretable, although in three cases the value of the LV apical rotation could not be determined. The mean rotation of the basal and apical planes at end-systole were -3.71° ± 0.84° and 6.73° ± 1.69° (n:18) respectively, resulting in a LV mean AMT of 10.48° ± 1.63° (n:18). End-systolic mean LVLS was 19.07 ± 2.71%. Cardiac MRI allows for the calculation of AMT and LVLS, fundamental functional components of the ventricular twist mechanics conditioned, in turn, by the anatomical helical layout of the myocardial fibers. These values provide complementary information about systolic ventricular function in relation to the traditional parameters used in daily practice.
SUMMARYThis paper presents a patient-sensitive simulation strategy capable of using the most efficient way the high-performance computational resources. The proposed strategy directly involves three different players: Computational Mechanics Scientists (CMS), Image Processing Scientists and Cardiologists, each one mastering its own expertise area within the project. This paper describes the general integrative scheme but focusing on the CMS side presents a massively parallel implementation of computational electrophysiology applied to cardiac tissue simulation. The paper covers different angles of the computational problem: equations, numerical issues, the algorithm and parallel implementation. The proposed methodology is illustrated with numerical simulations testing all the different possibilities, ranging from small domains up to very large ones. A key issue is the almost ideal scalability not only for large and complex problems but also for medium-size meshes. The explicit formulation is particularly well suited for solving this highly transient problems, with very short time-scale.
A through description of the left ventricle functionality requires combining complementary regional scores. A main limitation is the lack of multiparametric normality models oriented to the assessment of regional wall motion abnormalities (RWMA). This paper covers two main topics involved in RWMA assessment. We propose a general framework allowing the fusion and comparison across subjects of different regional scores. Our framework is used to explore which combination of regional scores (including 2-D motion and strains) is better suited for RWMA detection. Our statistical analysis indicates that for a proper (within interobserver variability) identification of RWMA, models should consider motion and extreme strains.
Longitudinal motion during in vivo pullbacks acquisition of intravascular ultrasound (IVUS) sequences is a major artifact for 3-D exploring of coronary arteries. Most current techniques are based on the electrocardiogram (ECG) signal to obtain a gated pullback without longitudinal motion by using specific hardware or the ECG signal itself. We present an image-based approach for cardiac phase retrieval from coronary IVUS sequences without an ECG signal. A signal reflecting cardiac motion is computed by exploring the image intensity local mean evolution. The signal is filtered by a band-pass filter centered at the main cardiac frequency. Phase is retrieved by computing signal extrema. The average frame processing time using our setup is 36 ms. Comparison to manually sampled sequences encourages a deeper study comparing them to ECG signals.
Abstract. Impairment of left ventricular contractility due to cardiovascular diseases is reflected in left ventricle (LV) motion patterns. An abnormal change of torsion or long axis shortening LV values can help with the diagnosis and follow-up of LV dysfunction. Tagged Magnetic Resonance (TMR) is a widely spread medical imaging modality that allows estimation of the myocardial tissue local deformation. In this work, we introduce a novel variational framework for extracting the left ventricle dynamics from TMR sequences. A bi-dimensional representation space of TMR images given by Gabor filter banks is defined. Tracking of the phases of the Gabor response is combined using a variational framework which regularizes the deformation field just at areas where the Gabor amplitude drops, while restoring the underlying motion otherwise. The clinical applicability of the proposed method is illustrated by extracting normality models of the ventricular torsion from 19 healthy subjects.
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