Automated 3-Dimensional Single-Beat Real-Time Volume Colour Flow Doppler Echocardiography in Children: A Validation Study of Right and Left Heart Flows

Kato, Atsuko; Sandoval, Juan Pablo; Mroczek, Dariusz; Chaturvedi, Rajiv; Houle, Hélène; Georgescu, Bogdan; Yoo, Shi‐Joon; Benson, Lee; Lee, Kyong‐Jin

doi:10.1016/j.cjca.2018.03.001

Cited by 7 publications

(4 citation statements)

References 26 publications

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“…have described the accuracy and feasibility of computing mitral, aortic, tricuspid, and pulmonic stroke volumes using three-dimensional FVCD in children, to compute valve areas and regurgitant volumes [5]. These authors have concluded that this technique potentially provides a non-invasive alternative to historically invasively acquired hemodynamic data and to cardiac magnetic resonance imaging [5]. Intracardiac flow is a key physiological event that, in most instances, mediates the clinical consequences of anatomical perturbations.…”

Section: Discussionmentioning

confidence: 99%

Combined flow-based imaging assessment of optimal cardiac resynchronization therapy pacing vector: a case report

et al. 2019

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Background There are still many pendent issues about the effective evaluation of cardiac resynchronization therapy impact on functional mitral regurgitation. In order to reduce the intrinsic difficulties of quantification of functional mitral regurgitation itself, an automatic quantification of real-time three-dimensional full-volume color Doppler transthoracic echocardiography was proposed as a new, rapid, and accurate method for the assessment of functional mitral regurgitation severity. Recent studies suggested that images of left ventricle flow by echo-particle imaging velocimetry could be a useful marker of synchrony. Echo-particle imaging velocimetry has shown that regional anomalies of synchrony/synergy of the left ventricle are related to the alteration, reduction, or suppression of the physiological intracavitary pressure gradients. Case summary We describe a case in which the two technologies are used in combination during acute echocardiographic optimization of left pacing vector in a 63-year-old man, Caucasian, who showed worsening heart failure symptoms a few days after an implant, and the effect of the device’s optimization at 6-month follow-up. Discussion The degree of realignment of hemodynamic forces, with quantitative analysis of the orientation of blood flow momentum ( φ ), can represent improvement of fluid dynamics synchrony of the left ventricle, and explain, with a new deterministic parameter, the effects of cardiac resynchronization therapy on functional mitral regurgitation. Real-time three-dimensional color flow Doppler quantification is feasible and accurate for measurement of mitral inflow, left ventricular outflow stroke volumes, and functional mitral regurgitation severity. Conclusion This clinical case offers an innovative and accurate approach for acute echocardiographic optimization of left pacing vector. It shows clinical utility of combined three-dimensional full-volume color Doppler transthoracic echocardiography/echo-particle imaging velocimetry assessment to increase response to cardiac resynchronization therapy, in terms of reduction of functional mitral regurgitation, improving fluid dynamics synchrony of the left ventricle. Electronic supplementary material The online version of this article (10.1186/s13256-019-2048-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Combined flow-based imaging assessment of optimal cardiac resynchronization therapy pacing vector: a case report

et al. 2019

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“…Three-dimensional printing in this arena has led to improved understanding of the pathophysiology of a wide range of anomalies and enhanced surgical planning, including for tetralogy of Fallot, atrial septal defect, and planning of intracardiac baffle placement in double-outlet RVs . Recently, fully automated measurements of RV volumes and EF based on machine-learning algorithms, using single-beat, real-time, 3-dimensional volume data sets, have been developed on cart, with the potential to assist busy echocardiography laboratories to incorporate 3-DE RV assessment into daily clinical practice . Three-dimensional, color-flow Doppler data sets are also being explored for stroke volume assessment, with the goal of being able to assess shunt hemodynamics using 3-dimensional color flow …”

Section: Future Directionsmentioning

confidence: 99%

“…Recently, fully automated measurements of RV volumes and EF based on machine-learning algorithms, using single-beat, real-time, 3-dimensional volume data sets, have been developed on cart, with the potential to assist busy echocardiography laboratories to incorporate 3-DE RV assessment into daily clinical practice . Three-dimensional, color-flow Doppler data sets are also being explored for stroke volume assessment, with the goal of being able to assess shunt hemodynamics using 3-dimensional color flow …”

Section: Future Directionsmentioning

confidence: 99%

New Directions in Right Ventricular Assessment Using 3-Dimensional Echocardiography

et al. 2019

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Two-dimensional echocardiographic evaluation of RV size and function includes measures of systolic basal longitudinal excursion (tricuspid annular plane systolic excursion and peak systolic velocity), fractional area change, and free-wall strain, all of which are measured from a single tomographic imaging plane: the RV-focused view. Given this limitation, clinical situations in which more accurate assessment of the RV or close patient follow-up were required were resolved with the use of cardiovascular magnetic resonance, computed tomography, and other modalities to obtain global measures of size and function (ie, volume and ejection fraction). With 3-dimensional echocardiography, both volume and ejection fraction assessments of the RV are possible with an accuracy and reproducibility close to that of cardiovascular magnetic resonance imaging. Further, 3-dimensional RV data sets can be cropped, sliced, and rotated to assess device leads, tricuspid valve leaflets, and RV wall-motion abnormalities. The 3-dimensional RV data set opens the horizon to endless possibilities for further exploration of novel parameters, including 3-dimensional RV shape and 3-dimensional RV deformation analysis. CONCLUSIONS AND RELEVANCEThe use of 3-dimensional echocardiography overcomes many of the limitations associated with conventional 2-dimensional echocardiography and has the potential to provide the detailed information required for the complex clinical decision-making that requires accurate, quantitative information about the RV.

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“…Kato et al apply automated, real-time 3-dimensional volume colour-flow Doppler echocardiography to obtain single-beat right-heart flow measurements in children with atrial shunts. 22 The feasibility of single-beat right-sided stroke-volume measurements provides a potentially valuable noninvasive index for children with CHD. Kowalik et al evaluate the use of several candidate biomarkers in predicting outcomes in adults (mean age: 36) with congenitally corrected transposition of the great arteries, concluding that a combination of high-sensitivity troponin values and systemic right-ventricular end-diastolic areas is the best predictor of adverse cardiovascular outcomes, with an area under the receiver-operating curve (AUC) of 0.79.…”

Section: Focus On Congenital Heart Disease and Pediatric Cardiologymentioning

confidence: 99%

The Canadian Journal of Cardiology: Open and Growing

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2019

Canadian Journal of Cardiology

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Automated 3-Dimensional Single-Beat Real-Time Volume Colour Flow Doppler Echocardiography in Children: A Validation Study of Right and Left Heart Flows

Cited by 7 publications

References 26 publications

Combined flow-based imaging assessment of optimal cardiac resynchronization therapy pacing vector: a case report

Combined flow-based imaging assessment of optimal cardiac resynchronization therapy pacing vector: a case report

New Directions in Right Ventricular Assessment Using 3-Dimensional Echocardiography

The Canadian Journal of Cardiology: Open and Growing

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