Real-time Three-dimensional Echocardiography for Determining Right Ventricular Stroke Volume in an Animal Model of Chronic Right Ventricular Volume Overload

Shiota, Takahiro; Jones, Michael; Chikada, Masahide; Fleishman, Craig E.; Castellucci, John; Cotter, Bruno; DeMaria, Anthony N.; Ramm, Olaf T. von; Kisslo, Joseph; Ryan, Thomas J.; Sahn, David J.

doi:10.1161/01.cir.97.19.1897

Cited by 149 publications

(59 citation statements)

References 15 publications

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“…Three-dimensional imaging techniques may have the potential to provide more accurate information for TV deformation and RV function and geometry. [25][26][27] …”

Section: Study Limitationsmentioning

confidence: 99%

Tricuspid Valve Tethering Predicts Residual Tricuspid Regurgitation After Tricuspid Annuloplasty

et al. 2005

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Background-Tricuspid valve (TV) annuloplasty is recommended for functional tricuspid regurgitation (TR), which is caused by TV annulus dilatation and tethering of the leaflets. However, the impact of TV deformations on the outcome of TV annuloplasty remains unknown. The goal of this study was to investigate the relationship between preoperative TV deformation and residual TR after TV annuloplasty. Methods and Results-Two hundred sixteen patients with functional TR had 2D echocardiography before and after TV annuloplasty. Right ventricular fractional area change and left ventricular ejection fraction were determined with the apical views. Minimal TV annulus diameter was determined by frame-by-frame analysis. The distance of TV tethering was measured from the annulus plane to the coaptation point and tethering area by tracing the leaflets from the annulus plane. TR severity was determined by the ratio of the maximal jet area to the corresponding right atrial area. The severity of residual TR was associated with age, right and left ventricular dysfunction, tethering distance and area, and severity of preoperative TR (all PϽ0.05). TV annular dimension was not associated with outcome of TV annuloplasty. Multivariate analysis revealed that age, tethering distance, and severity of preoperative TR (all PϽ0.001) were independent parameters predicting residual TR. The sensitivity and specificity in predicting residual TR after surgery were 86% and 80% for tethering distances Ͼ0.76 cm and 82% and 84% for tethering areas Ͼ1.63 cm 2 , respectively. Conclusions-Severe TV tethering predicted residual TR after TV annuloplasty, whereas preoperative TV annular dimension was not associated with outcome of TV annuloplasty.

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“…Three-dimensional imaging techniques may have the potential to provide more accurate information for TV deformation and RV function and geometry. [25][26][27] …”

Section: Study Limitationsmentioning

confidence: 99%

Tricuspid Valve Tethering Predicts Residual Tricuspid Regurgitation After Tricuspid Annuloplasty

et al. 2005

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“…Several recent studies have demonstrated the potential improvements in the evaluation of global LV function from RT3DE data. 10,11 However, analysis procedures applied to 3D data did not fully exploit the volumetric information, because they were still based on tracing of endocardial boundaries on selected planes and on geometric modeling. 12 Because modeling may be inaccurate under certain conditions, the use of information limited to 2 dimensions renders this procedure subject to many of the same limitations as the techniques used to analyze 2DE images.…”

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confidence: 99%

Volumetric Quantification of Global and Regional Left Ventricular Function From Real-Time Three-Dimensional Echocardiographic Images

et al. 2005

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Background-Real-time 3D echocardiographic (RT3DE) data sets contain dynamic volumetric information on cardiac function. However, quantification of left ventricular (LV) function from 3D echocardiographic data is performed on cut-planes extracted from the 3D data sets and thus does not fully exploit the volumetric information. Accordingly, we developed a volumetric analysis technique aimed at quantification of global and regional LV function. Methods and Results-RT3DE images obtained in 30 patients (Philips 7500) were analyzed by use of custom software based on the level-set approach for semiautomated detection of LV endocardial surface throughout the cardiac cycle, from which global and regional LV volume (LVV)-time and wall motion (WM)-time curves were obtained. The study design included 3 protocols. In protocol 1, time curves obtained in 16 patients were compared point-by-point with MRI data (linear regression and Bland-Altman analyses). Global LVV correlated highly with MRI (rϭ0.98; yϭ0.99xϩ2.3) with minimal bias (1.4 mL) and narrow limits of agreement (Ϯ20 mL). WM correlated highly only in basal and midventricular segments (rϭ0.88; yϭ0.85xϩ0.7).In protocol 2, we tested the ability of this technique to differentiate populations with known differences in LV function by studying 9 patients with dilated cardiomyopathy and 9 normal subjects. All calculated indices of global and regional systolic and diastolic LV function were significantly different between the groups. In protocol 3, we tested the feasibility of automated detection of regional WM abnormalities in 11 patients. In each segment, abnormality was detected when regional shortening fraction was below a threshold obtained in normal subjects. The automated detection agreed with expert interpretation of 2D WM in 86% of segments. Conclusions-Volumetric

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“…The new functional imaging approach may yield important kinematic information on the distribution of instantaneous velocities in the RV diastolic flow field of specific normal or diseased hearts. cardiac image analysis; ventricular function; cardiac fluid dynamics; right ventricle; heart chamber volume QUANTITATIVE ANALYSIS of three-dimensional (3-D) digital cardiac images has become increasingly important given the recent advances in the digital cardiac imaging techniques of 3-D echocardiography, magnetic resonance imaging, computed tomography, and digital fluoroscopy (1,24,26). The growth of these digital imaging techniques is accompanied by an increasing usage of image manipulation tools, providing more elaborate image analysis and measurement and quantitative evaluation and leading to more refined diagnostic accuracy than visual interpretation alone.…”

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confidence: 99%

RV functional imaging: 3-D echo-derived dynamic geometry and flow field simulations

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Shu

Womack

et al. 2003

American Journal of Physiology-Heart and Circulatory Physiology

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We describe a novel functional imaging approach for quantitative analysis of right ventricular (RV) blood flow patterns in specific experimental animals (or humans) using real-time, three-dimensional (3-D) echocardiography (RT3D). The method is independent of the digital imaging modality used. It comprises three parts. First, a semiautomated segmentation aided by intraluminal contrast medium locates the RV endocardial surface. Second, a geometric scheme for dynamic RV chamber reconstruction applies a time interpolation procedure to the RT3D data to quantify wall geometry and motion at 400 Hz. A volumetric prism method validated the dynamic geometric reconstruction against simultaneous sonomicrometric canine measurements. Finally, the RV endocardial border motion information is used for mesh generation on a computational fluid dynamics solver to simulate development of the early RV diastolic inflow field. Boundary conditions (tessellated endocardial surface nodal velocities) for the solver are directly derived from the endocardial geometry and motion information. The new functional imaging approach may yield important kinematic information on the distribution of instantaneous velocities in the RV diastolic flow field of specific normal or diseased hearts. cardiac image analysis; ventricular function; cardiac fluid dynamics; right ventricle; heart chamber volume QUANTITATIVE ANALYSIS of three-dimensional (3-D) digital cardiac images has become increasingly important given the recent advances in the digital cardiac imaging techniques of 3-D echocardiography, magnetic resonance imaging, computed tomography, and digital fluoroscopy (1,24,26). The growth of these digital imaging techniques is accompanied by an increasing usage of image manipulation tools, providing more elaborate image analysis and measurement and quantitative evaluation and leading to more refined diagnostic accuracy than visual interpretation alone. Moreover, complex mathematical procedures are being used to localize and highlight important changes in cardiac function that cannot be visually detected directly from the original images. With the concurrent development of high-performance computers and analytical software, a functional sort of imaging can now evolve, geared toward the creation of physiological images that are the result of a mathematical simulation derived from a set of images. Such functional imaging will allow visualization and understanding of the evolution of any dynamic process of interest (filling, ejection) within the heart. Accordingly, it should allow better insights into cardiac physiology and pathophysiology and may possibly detect warning signs of diseases not yet overt.This study developed innovative dynamic geometric chamber reconstruction models for use in functional imaging analyses of right ventricular (RV) filling dynamics and physiology. With the use of a new volumetric "prism method," it is first shown that the geometric chamber reconstructions provide accurate and reliable dynamic instantaneous RV chamber geometry ...

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Real-time Three-dimensional Echocardiography for Determining Right Ventricular Stroke Volume in an Animal Model of Chronic Right Ventricular Volume Overload

Abstract: The real-time 3D system provided good estimation of strictly quantified reference RV stroke volumes, suggesting an important application of this new 3D method.

Cited by 149 publications

References 15 publications

Tricuspid Valve Tethering Predicts Residual Tricuspid Regurgitation After Tricuspid Annuloplasty

Tricuspid Valve Tethering Predicts Residual Tricuspid Regurgitation After Tricuspid Annuloplasty

Volumetric Quantification of Global and Regional Left Ventricular Function From Real-Time Three-Dimensional Echocardiographic Images

RV functional imaging: 3-D echo-derived dynamic geometry and flow field simulations

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