scholarly journals An Integrated and Automated Tool for Quantification of Biomechanics in Fetal and Neonatal Echocardiography

2020 ◽  
Author(s):  
Brett A. Meyers ◽  
Melissa C. Brindise ◽  
R. Mark Payne ◽  
Pavlos P. Vlachos
Keyword(s):  
Energy Loss ◽  
Longitudinal Strain ◽  
Color Doppler ◽  
Global Longitudinal Strain ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Flow Energy ◽  
Control Subjects ◽  
Flow Energy Loss ◽  
Early Filling

AbstractObjectivesTo show simultaneous quantification of flow and mechanics of cardiac function from fetal and neonatal echocardiograms using an integrated set of automated, physics-based, echocardiography analysis methods.BackgroundQuantifying ventricular biomechanics from fetal and neonatal echocardiograms presents unique and significant challenges. Existing analysis tools are designed for adults and cannot accurately assess fetal subjects.MethodsWe used in-house developed analysis algorithms to quantify ventricular biomechanics from four-chamber B-mode and color Doppler routine examinations recordings for three hypoplastic left heart (HLHS) patients at 33-weeks’ gestation and first week post-birth along with age-matched controls. Chamber morphology, tissue motion, atrioventricular valve inflow, global longitudinal strain, and hemodynamic flow parameters were measured.ResultsPrenatal cardiac output differed between control (LV:157 ± 139 mL/min, RV:257 ± 218 mL/min) and HLHS subjects (410 ± 128 mL/min). This difference persisted for control (LV:233 ± 74 mL/min, RV:242 ± 140 mL/min) and HLHS subjects (637 ± 298 mL/min) after birth. Peak global longitudinal strain measurements did not differ in utero between control (LV: 12.2 ± 4.1%, RV:12.1 ± 4.9%) and HLHS subjects (RV:12.7± 4.2%). After birth, myocardial contraction increased for the control (LV:15.4 ± 2.8%, RV:22.9 ± 6.9%) and HLHS subjects (14.4 ± 6.2%). Postnatal early filling mitral flow velocity for the control subjects (LV:58.8 ± 17.6 cm/s) and early-filling tricuspid flow of the HLHS subjects (64.8 ± 23.7cm/s) were similar, while the late filling velocity decreased for the control subject LV (33.5 ± 8.1 cm/s) compared to the HLHS subjects (66.9 ± 23.0 cm/s). Importantly, flow energy loss in the fetal HLHS hearts was increased (0.35 ± 0.19 m3/s2) compared to the control subjects (LV:0.09 ± 0.07 m3/s2, RV:0.17 ± 0.12 m3/s2), and further increased postnatally for the HLHS subjects (0.55 ± 0.24 m3/s2) compared to the control subjects (LV:0.23 ± 0.20 m3/s2, RV:0.09 ± 0.06 m3/s2).ConclusionsWe demonstrate the feasibility of integrated quantitative measurements of fetal and neonatal ventricular hemodynamics and biomechanics using only four-chamber B-mode and color Doppler recordings.Short AbstractWe integrated novel echocardiogram analysis methods to quantify ventricular flow and mechanics using apical long-axis B-mode and color Doppler imaging from fetal and neonatal subjects. Three hypoplastic left heart patients (HLHS) imaged at 33-weeks gestation and again in the first postnatal week, along with age-matched controls, were evaluated. For the first time, we show quantified hemodynamics from fetal echocardiography using flow reconstruction, flow energy loss, and intraventricular pressure, as well as global strain and strain rate. These tools are capable of longitudinal analysis of ventricle maturation, flow dynamics, and quantified measurements from routine examinations of complex congenital heart disease.

Flow Energy Loss as a Predictive Parameter for Right Ventricular Deterioration Caused by Pulmonary Regurgitation After Tetralogy of Fallot Repair

2018 ◽  
Vol 39 (4) ◽  
pp. 731-742 ◽  
Author(s):  
Miyuki Shibata ◽  
Keiichi Itatani ◽  
Taiyu Hayashi ◽  
Takashi Honda ◽  
Atsushi Kitagawa ◽  
...  
Keyword(s):  
Energy Loss ◽  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Pulmonary Regurgitation ◽  
Flow Energy ◽  
Flow Energy Loss ◽  
Tetralogy Of Fallot Repair

scholarly journals Deformation of the left heart chambers in hypertensive postmenopausal women, depending on the presence of left ventricular hypertrophy and left atrium dilation

2019 ◽  
Vol 26 (3) ◽  
pp. 17-26
Author(s):  
M. Yu. Kolesnyk ◽  
M. V. Sokolova
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Postmenopausal Women ◽  
Longitudinal Strain ◽  
Ventricular Hypertrophy ◽  
Blood Pressure Monitoring ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Heart ◽  
Hypertensive Patients ◽  
Healthy Women

The aim – to assess the longitudinal deformation (strain) of the left heart chambers in postmenopausal women with essential hypertension (EH), depending on the presence of left ventricular hypertrophy (LVH) and left atrial (LA) dilation. Materials and methods. The study involved 126 postmenopausal women: 100 patients with EH I–II stages of the main group and 26 practically healthy women of the comparison group. Patients with EH were divided into two groups: 32 patients without structural changes of the myocardium and 68 women with LVH and/or LA dilation. In all patients we performed ambulatory blood pressure monitoring, standard transthoracic echocardiography and speckle-tracking echocardiography. The global longitudinal strain (GLS) of LV and deformation of the endocardial (endo), middle (mid) and epicardial (epi) layers of myocardium were analyzed. Analysis of LA deformation was performed using two (from the beginning of the R-wave and from the apex of the R-wave) variants of ECG-synchronization. The LA longitudinal strain (LS) was evaluated in reservoir and contraction phase in two positions with the calculation of the GLS LA. Results and discussion. We found changes in LV multilayer deformation as LS decreasing in the endocardial, middle and epicardial layers in hypertensive patients in the early stages of disease, even before the development of LVH. Damage of LA deformation preceded its dilation. Both types of ECG-synchronization showed a statistically significant decrease of LA strain in the reservoir phase in all hypertensive patients in comparison with healthy women. A decreasing LA GLS in women with EH and structurally normal heart compared to the healthy group was detected only by using ECG-synchronization with R-wave, which is considered more universal. Conclusion. A decrease of LA and LV LS in postmenopausal women is recorded even before the development of LVH and LA dilation. The LV LS became lower in all layers of myocardium – from endocardial to epicardial. Changes in the LA LS in postmenopausal women with EH begin with a damage of reservoir phase even with normal size of LA and a LV myocardial mass index.

scholarly journals Hypoplastic Left Heart Syndrome: Diagnostic Difficulties in Prenatal Period

2021 ◽  
Vol 18 (5) ◽  
pp. 416-422
Author(s):  
Nodira M. Normuradova ◽  
Аkram A. Fazilov ◽  
Munisa M. Rasulova
Keyword(s):  
Hypoplastic Left Heart Syndrome ◽  
Color Doppler ◽  
Ductus Arteriosus ◽  
Interventricular Septum ◽  
Diagnostic Errors ◽  
Prenatal Period ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Atrioventricular Canal ◽  
Left Heart Syndrome

The article discusses the possible diagnostic errors in the hypoplastic left heart syndrome (HLHS) with mitral atresia and intact interventricular septum. “Atrioventricular canal defects” can be commonly and mistakenly diagnosed the prenatal period in such cases. The aspects and possibilities of differential diagnosis of these defects in the prenatal period are discussed. Ultrasound sign is presented in the article, we have named it “hockey stick with puck” that characterizes the retrograde blood flow in the aortic arch. This sign is diagnosed by color Doppler mapping of the sagittal section of the ductus arteriosus and can serve as a marker of mitral/aortic atresia.

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