Is It Time to Revise the Guidelines and Recommendations for Digital Echocardiography?

Tyomkin, Vladimir; Vered, Zvi; Mor, Michael; Blondheim, David; Carasso, Shemy; Shimoni, Sara; Goland, Sorel; Beeri, Rоnen; Gilon, Dan; Zekry, Sagit Ben; Sagie, Alik; Cohen, Noah Liel; Yosefy, Chaim; Pery, Marina; Leitman, Marina

doi:10.1016/j.echo.2018.01.021

Cited by 5 publications

(5 citation statements)

References 3 publications

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“…Visual and quantitative analysis of left ventricular function, calculation of strain, and myocardial work index during high heart rates more than 120/min is problematic on the echocardiography monitors with fixed [non-adaptive] refresh rate, as some frames are distorted or explained twice or dropped. Recently introduced monitors with a high adaptive refresh rate allow an adequate solution to this problem 18 , 19 . As well, a better quality of modern echocardiography systems makes echocardiography images more suitable for speckle tracking imaging analysis.…”

Section: Discussionmentioning

confidence: 99%

Myocardial work index during normal dobutamine stress echocardiography

Leitman

Balboul

Burgsdorf

et al. 2022

Sci Rep

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Dobutamine stress echocardiography is an alternative method to exercise stress echocardiography for the evaluation of ischemia. Recently, the novel speckle tracking imaging derived parameter, myocardial work index, was suggested for the evaluation of cardiac performance and was evaluated during exercise stress echocardiography. In this study, we analyzed the effect of dobutamine on myocardial work index variables during normal dobutamine stress echocardiography. Echocardiography examinations of patients with normal dobutamine stress echocardiography were collected and underwent off-line speckle tracking imaging analysis. Myocardial work index parameters were calculated at each dose of dobutamine and compared. 286 patients underwent dobutamine stress echocardiography during the study period. 102 patients were excluded due to pre-existed coronary artery disease or ischemia at dobutamine stress echocardiography. 65 patients were excluded due to suboptimal image quality unsuitable for speckle tracking imaging analysis. The remaining 119 patients with normal results were included. The global work index decreased from 2393.3 to 1864.7 mmHg%, p < 0.0004. Global constructive work decreased from 2681.7 to 2152.6 mmHg%, p = 0.001. Global wasted work increased from 78.8 to 128.3 mmHg%, p < 0.003. Global work efficacy decreased from 96.1 to 91.9%, p < 0.00001. Global strain increased from—19.6 to − 23.7%, p < 0.00001. Dobutamine stress echocardiography results in a decrease of all specific myocardial work index parameters even in normal subjects. Only global myocardial strain improved.

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Section: Discussionmentioning

confidence: 99%

Myocardial work index during normal dobutamine stress echocardiography

Leitman

Balboul

Burgsdorf

et al. 2022

Sci Rep

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“…3D-CSN was designed to execute semantic segmentation for determining the ROI of motion estimation network and initializing LVM position. Noise is a long-standing difficulty in the field of motion estimation in echocardiography (33). We mask the ultrasound image to remove redundant input signals and determine the LVM wall boundary.…”

Section: Discussionmentioning

confidence: 99%

Myocardial strain analysis of echocardiography based on deep learning

Deng

Cai

Zhang

et al. 2022

Front. Cardiovasc. Med.

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BackgroundStrain analysis provides more thorough spatiotemporal signatures for myocardial contraction, which is helpful for early detection of cardiac insufficiency. The use of deep learning (DL) to automatically measure myocardial strain from echocardiogram videos has garnered recent attention. However, the development of key techniques including segmentation and motion estimation remains a challenge. In this work, we developed a novel DL-based framework for myocardial segmentation and motion estimation to generate strain measures from echocardiogram videos.MethodsThree-dimensional (3D) Convolutional Neural Network (CNN) was developed for myocardial segmentation and optical flow network for motion estimation. The segmentation network was used to define the region of interest (ROI), and the optical flow network was used to estimate the pixel motion in the ROI. We performed a model architecture search to identify the optimal base architecture for motion estimation. The final workflow design and associated hyperparameters are the result of a careful implementation. In addition, we compared the DL model with a traditional speck tracking algorithm on an independent, external clinical data. Each video was double-blind measured by an ultrasound expert and a DL expert using speck tracking echocardiography (STE) and DL method, respectively.ResultsThe DL method successfully performed automatic segmentation, motion estimation, and global longitudinal strain (GLS) measurements in all examinations. The 3D segmentation has better spatio-temporal smoothness, average dice correlation reaches 0.82, and the effect of target frame is better than that of previous 2D networks. The best motion estimation network achieved an average end-point error of 0.05 ± 0.03 mm per frame, better than previously reported state-of-the-art. The DL method showed no significant difference relative to the traditional method in GLS measurement, Spearman correlation of 0.90 (p < 0.001) and mean bias −1.2 ± 1.5%.ConclusionIn conclusion, our method exhibits better segmentation and motion estimation performance and demonstrates the feasibility of DL method for automatic strain analysis. The DL approach helps reduce time consumption and human effort, which holds great promise for translational research and precision medicine efforts.

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“…As we described previously (2), in the vast majority of echo systems, the exported frame rate is set to 30 fps, echocardiography image compression is set to 80-96% of JPEG quality, and monitors of the echocardiography workstations were not suitable for echocardiography examinations (2). All the main compounds that are responsible for echocardiography image quality today can be managed easily, especially in the era of digital archives, which might be easily accessible for retrieving images of diagnostic quality.…”

Section: Discussionmentioning

confidence: 99%

“…In echocardiography, monitors should be optimized for the observation of echocardiography video clips, meaning that the refresh rate of the monitor should match the frame rate of the displayed video. Therefore, monitors with an adaptive refresh rate (that adapt their own refresh rate to the frame rate of the displayed video), are the best choice for echocardiography (2,7). These are today available on the market.…”

Section: Discussionmentioning

confidence: 99%

“…In the opposite case, the displayed video obtained at a lower frame rate led to inconsistencies in the sequence of reproduced frames: for example, in a video with a frame rate of 45 fps, 2 frames are played at the rate of 60 fps, and each 3rd frame is twice prolonged at 30 fps (with resulting average frame rate of 45 fps). This problem is known as "the jitter effect" (2). If the video frame rate cannot be divided by the monitor frame rate, some frames are just not rendered and "disappear" (2).…”

Section: Viewing Monitors and Eye Strainmentioning

confidence: 99%

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Pitfalls of Echocardiographic Image Perception: How to Overcome Them?

2022

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In recent years, the significant development of echocardiography systems has led to a sharp improvement in echocardiographic images' quality. In parallel with this, computerized technologies are also going far forward, which today make it possible to ensure a high level of transmission, storage, and display of echocardiography studies. Despite this, many cardiologists are not familiar with modern computerized technologies' new possibilities and continue to use the old standards. That is why many echocardiography laboratories with the best echocardiography systems work following the old minimalist approach. In this paper, we will look at some of the most common mistakes that result from the improper transmission, storage, and demonstration of echocardiography studies, and describe possible ways to overcome these problems.

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Is It Time to Revise the Guidelines and Recommendations for Digital Echocardiography?

Cited by 5 publications

References 3 publications

Myocardial work index during normal dobutamine stress echocardiography

Myocardial work index during normal dobutamine stress echocardiography

Myocardial strain analysis of echocardiography based on deep learning

Pitfalls of Echocardiographic Image Perception: How to Overcome Them?

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