Generalized Transformed Hough: Segmentation of Contours in Angiographic Images

Author(s):  
Oscar Eduardo Gualdron

<span lang="EN-US">The morphologic and functional study of cardiovascular system is of vital importance because problems related to this system are one of the main causes of   mortality in the world. It is important to mention that the left ventricle (VI) is the most susceptible to suffer severe damage, in diseases, such as arterial hypertension, mellitus diabetes or arteriosclerosis. This article presents a new methodology directed to segmentation of left ventricular contours, in angiographic images by using Generalized Hough Transform (TGH). It is important to obtain the ventricular edge, because analyzing processes of systole and diastole end, it is possible to calculate parameters of the cardiac functionality as the end-diastolic volume, end systolic volume, ejection fraction, cardiac output, Hyperkinéticos, Hypokinéticos segments, and normal; in this work we focus only on the removal of the same. </span>

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Bombardini ◽  
A Zagatina ◽  
Q Ciampi ◽  
L Cortigiani ◽  
A D'Andrea ◽  
...  

Abstract Background Two-dimensional (2-D) volumetric exercise stress echocardiography (ESE) provides an integrated view of preload reserve through end-diastolic volume (EDV) and left ventricular contractile reserve (LVCR) through end-systolic volume (ESV) changes. Purpose To assess the dependence of stroke volume (SV) and cardiac output (CO) upon LVCR EDV changes and heart rate (HR) during ESE. Methods We prospectively performed semi-supine bicycle or treadmill ESE in 1,344 patients (age 59.8±11.4 years; 550 female; ejection fraction = 62.5±8%) referred for known or suspected coronary artery disease in 20 quality controlled laboratories of 16 countries from 2016 to 2019. SV was calculated at rest and peak stress from raw measurement of LV EDV and ESV by biplane Simpson rule, 2-D echo. LVCR was the stress-rest ratio of force (systolic blood pressure by cuff sphygmomanometer/ESV, abnormal values &lt;2.0 identify a “weak” heart). Preload reserve was defined by an increase in LV EDV. Abnormal values (lack of EDV increase, peak EDV ≤ rest EDV) identify a “stiff” heart. Cardiac output was calculated as SV * HR (measured with standard EKG). HR reserve (stress/rest ratio) &lt;1.85 identifies a “slow” heart with chronotropic incompetence. Results By selection, all patients had negative SE by wall motion criteria. Of the 1,344 patients included in the study, 448 belonged to the lowest tertile of CO increase. Of them 326 (73%) achieved HR reserve &lt;1.85; 220 (49%) had a blunted LVCR and 374 (83%) a reduction of preload reserve, with 348 patients (78%) showing ≥2 abnormalities. The more the abnormal criteria, the worse the CO response, which was lowest in slow, stiff and weak hearts: see figure. Conclusion Patients with normal CO reserve during exercise usually have a fast, compliant and strong heart. Abnormal CO reserve is associated with heterogeneous hemodynamic responses, with slow, stiff and/or weak hearts. The clarification of underlying hemodynamic heterogeneity is the prerequisite for a personalized treatment, and can be easily extracted from a standard 2-D volumetric SE. Hearts with normal CO are all alike; every heart with abnormal CO is abnormal in its own way. CO % changes in subsets (*p&lt;0.001) Funding Acknowledgement Type of funding source: None


Author(s):  
Tiantian Shen ◽  
Lin Xia ◽  
Wenliang Dong ◽  
Jiaxue Wang ◽  
Feng Su ◽  
...  

Background: Preclinical and clinical evidence suggests that mesenchymal stem cells (MSCs) may be beneficial in treating heart failure (HF). However, the effects of stem cell therapy in patients with heart failure is an ongoing debate and the safety and efficacy of MSCs therapy is not well-known. We conducted a systematic review of clinical trials that evaluated the safety and efficacy of MSCs for HF. This study aimed to assess the safety and efficacy of MSCs therapy compared to the placebo in heart failure patients. Methods: We searched PubMed, Embase, Cochrane library systematically, with no language restrictions. Randomized controlled trials(RCTs) assessing the influence of MSCs treatment function controlled with placebo in heart failure were included in this analysis. We included RCTs with data on safety and efficacy in patients with heart failure after mesenchymal stem cell transplantation. Two investigators independently searched the articles, extracted data, and assessed the quality of the included studies. Pooled data was performed using the fixed-effect model or random-effect model when it appropriate by use of Review Manager 5.3. The Cochrane risk of bias tool was used to assess bias of included studies. The primary outcome was safety assessed by death and rehospitalization and the secondary outcome was efficacy which was assessed by six-minute walk distance and left ventricular ejection fraction (LVEF),left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV) and brain natriuretic peptide(BNP) Results: A total of twelve studies were included, involving 823 patients who underwent MSCs or placebo treatment. The overall rate of death showed a trend of reduction of 27% (RR [CI]=0.73 [0.49, 1.09], p=0.12) in the MSCs treatment group. The incidence of rehospitalization was reduced by 47% (RR [CI]=0.53[0.38, 0.75], p=0.0004). The patients in the MSCs treatment group realised an average of 117.01m (MD [95% CI]=117.01m [94.87, 139.14], p<0.00001) improvement in 6MWT.MSCs transplantation significantly improved left ventricular ejection fraction (LVEF) by 5.66 % (MD [95% CI]=5.66 [4.39, 6.92], p<0.00001), decreased left ventricular end-systolic volume (LVESV) by 14.75 ml (MD [95% CI]=-14.75 [-16.18, -12.83], p<0.00001 ) and left ventricular end-diastolic volume (LVEDV) by 5.78 ml (MD [95% CI]=-5.78[-12.00, 0.43], p=0.07 ) ,in the MSCs group , BNP was decreased by 133.51 pg/ml MD [95% CI]= -133.51 [-228.17,-38.85], p=0.54, I2= 0.0%) than did in the placebo group. Conclusions: Our results suggested that mesenchymal stem cells as a regenerative therapeutic approach for heart failure is safe and effective by virtue of their self-renewal potential, vast differentiation capacity and immune modulating properties. Allogenic MSCs have superior therapeutic effects and intracoronary injection is the optimum delivery approach. In the tissue origin, patients who received treatment with umbilical cord MSCs seem more effective than bone marrow MSCs. As to dosage injected, (1-10)*10^8 cells were of better effect.


1986 ◽  
Vol 251 (6) ◽  
pp. H1101-H1105 ◽  
Author(s):  
G. D. Plotnick ◽  
L. C. Becker ◽  
M. L. Fisher ◽  
G. Gerstenblith ◽  
D. G. Renlund ◽  
...  

To evaluate the extent to which the Frank-Starling mechanism is utilized during successive stages of vigorous upright exercise, absolute left ventricular end-diastolic volume and ejection fraction were determined by gated blood pool scintigraphy at rest and during multilevel maximal upright bicycle exercise in 30 normal males aged 26-50 yr, who were able to exercise to 125 W or greater. Left ventricular end-systolic volume, stroke volume, and cardiac output were calculated at rest and during each successive 3-min stage of exercise [25, 50, 75, 100, and 125–225 W (peak)]. During early exercise (25 W), end-diastolic and stroke volumes increased (+17 +/- 1 and +31 +/- 4%, respectively), with no change in end-systolic volume. With further exercise (50–75 W) end-diastolic volume remained unchanged as end-systolic volume decreased (-12 +/- 4 and -24 + 5%, respectively). At peak exercise end-diastolic volume decreased to resting level, stroke volume remained at a plateau, and end-systolic volume further decreased (-48 +/- 7%). Thus the Frank-Starling mechanism is used early in exercise, perhaps because of a delay in sympathetic mobilization, and does not appear to play a role in the later stages of vigorous exercise.


1986 ◽  
Vol 250 (1) ◽  
pp. H131-H136
Author(s):  
J. L. Heckman ◽  
L. Garvin ◽  
T. Brown ◽  
W. Stevenson-Smith ◽  
W. P. Santamore ◽  
...  

Biplane ventriculography was performed on nine intact anesthetized rats. Images of the left ventricle large enough for analysis were obtained by placing the rats close to the radiographic tubes (direct enlargement). Sampling rates, adequate for heart rates of 500 beats/min, were obtained by filming at 500 frames/s. From the digitized silhouettes of the left ventricle the following information was obtained (means +/- SE): end-diastolic volume 0.60 +/- 0.03 ml, end-systolic volume 0.22 +/- 0.02 ml, stroke volume 0.38 +/- 0.02 ml, ejection fraction 0.63 +/- 0.02, cardiac output 118 +/- 7 ml/min, diastolic septolateral dimension 0.41 +/- 0.01 mm, diastolic anteroposterior dimension 0.40 +/- 0.01 mm, diastolic base-to-apex dimension 1.58 +/- 0.04 mm. To determine the accuracy with which the volume of the ventricle could be measured, 11 methyl methacrylate casts of the left ventricle were made. The correlation was high (r = 0.99 +/- 0.02 ml E) between the cast volumes determined by water displacement and by use of two monoplane methods (Simpson's rule of integration and the area-length method applied to the analysis of the anteroposterior films) and a biplane method (area-length). These results demonstrate that it is possible to obtain accurate dimensions and volumes of the rat left ventricle by use of high-speed ventriculography.


2021 ◽  
Vol 2114 (1) ◽  
pp. 012006
Author(s):  
M K Mohammed ◽  
S I Essa

Abstract Ischemic heart disease is a major causes of heart failure. Heart failure patients have predominantly left ventricular dysfunction (systolic or diastolic dysfunction, or both). Acute heart failure is most commonly caused by reduced myocardial contractility, and increased LV stiffness. We performed echocardiography and gated SPECT with Tc99m MIBI within 263 patients and 166 normal individuals. Left ventricular end systolic volume (LVESV), left ventricular end diastolic volume (LVEDV), and left ventricular ejection fraction (LVEF) were measured. For all degrees of ischemia, there was a significant difference between ejection fraction values measured by SPECT and echocardiography, and there were no significant differences among end systolic volume and end diastolic volume value calculated by two methods for all cases. The mean value for EDV (ECHO)/EDV (SPECT) was 1.07 ± 0.31 for degree (1, 2); in the degree 3 the mean value was 1.02 ± 0.08, and 1.005 ± 0.07 for degree 4. The mean value for ESV (ECHO)/ESV (SPECT) was 1.08 ± 0.34 for degree (1, 2); while 1.03 ± 0.12, 1.021 ± 0.128 for degree 3 and 4 respectively. This study was showed a good relation between left ventricular size and ejection fraction measured by SPECT with Tc99m, and echocardiography.


1963 ◽  
Vol 204 (3) ◽  
pp. 446-450 ◽  
Author(s):  
Franz J. Hallermann ◽  
G. C. Rastelli ◽  
H. J. C. Swan

In each of 12 mongrel dogs, data for end-diastolic volume, end-systolic volume, and stroke volume of the left ventricle were obtained by two independent methods: the indicator dilution method and a radiographic method. While the values for stroke volume showed good agreement between the two methods, a significant and directionally constant difference was found between values for end-diastolic volume and end-systolic volume calculated by the two different methods. This was observed in dogs with fast heart rates (exceeding 150 beats/min), as well as in dogs with heart rates of about 100 beats/min. The findings strongly suggest that a fundamental error is present in estimations of volume based on the washout of an indicator dye.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Mia Cokljat ◽  
Nicholas Bunce ◽  
Taigang He ◽  
Debasish Banerjee

Abstract Background and Aims Sudden cardiac death rates are higher in patients with CKD and on haemodialysis. Hypotheses include the presence of diffuse myocardial fibrosis secondary to fluid and toxin overload. Native T1, T2 and T2* mapping through cardiac magnetic resonance (CMR) is emerging as a novel technique to quantify myocardial fibrosis. This pilot study aimed to quantify cardiac morphological change using CMR native T1, T2 and T2* mapping and correlate with autonomic provocation testing, in CKD 3b-5 and haemodialysis patients. Method Patients with stable CKD 3b and higher, and patients on haemodialysis (CKD-haemodilaysis) underwent a non-contrast CMR, which included native T1, T2, T2* mapping. Autonomic provocation testing was performed using a dipolar ECG lead, followed by 14-days of recording. Results were compared between patient groups, and T1, T2, T2* maps compared to healthy controls using the student t test and Kruskal-Wallis tests. Results Nine CKD, eight haemodialysis and seven control patients were recruited (Table 1). Of the late-stage CKD patients, three were stage 3b, four were stage 4 and two were stage 5. There were no significant differences between the two patient groups in baseline characteristics (Table 1). There were no significant differences between CKD and CKD-haemodialysis patients in left ventricular end-diastolic volume index, left ventricular end-systolic volume index, right ventricular end-diastolic volume index, right ventricular end-systolic volume index, ejection fraction, and left ventricular mass index (71.1±15.2 vs. 80.51 ±21.9 ml/m2, p=0.316; 24.4±7.09 vs. 34.4±19.4 ml/m2, p=0.171; 67.11 ± 14.9 vs. 75.5±23.4 ml/m2, p=0.386; 22.2±4.87 vs. 23.9±9.93 ml/m2, p=0.663; 65.8±6.34 vs. 59.5±12.4 %, p=0.200; 48.4±8.60 vs. 50.5±11.0 g/m2, p=0.673). T1 and T2 were significantly increased in CKD and CKD-haemodialysis patients compared to healthy controls (1259±57.7 vs. 1204±22.3 ms, p=0.038 and 49.1±4.74 vs. 42.0±2.79 ms, p=0.034). There was no difference in T2* star (32.8±7.59 vs. 28.8±3.77, p=0.291). There was no significant difference in native T1, T2 and T2* times between CKD and CKD-haemodialysis patients (1247±66.7 vs. 1273±45.7, p=0.361; 49.1±5.22 vs. 49.0±4.49, p=0.960; 34.1±7.57 vs. 31.3±7.81, p=0.769). Mean percentage change of HR in CKD patients from lying to sitting to standing was 4.51%±6.66 and 11.5%±11.8 respectively. Mean percentage change of HR in CKD-haemodialysis from lying to sitting to standing was 2.15%±6.30 and 6.0%±4.45 respectively. There were no significant differences in postural HR variability between CKD and CKD-haemodialysis patients (p=0.478 and p=0.237). Conclusion In late stage CKD, cardiac volumes, mass, ejection fraction and native T1, T2 and T2* are comparable to those of patients on long-term haemodialysis. However native T1 and T2 times are significantly elevated in later stage CKD and haemodialysis, compared to healthy controls. Heart rate changes over postural provocation are comparable between CKD and CKD-haemodialysis patients, although autonomic response is reduced compared to previously published data in healthy controls. Processes that drive myocardial fibrosis may start earlier in CKD pathogenesis.


1975 ◽  
Vol 228 (2) ◽  
pp. 536-542 ◽  
Author(s):  
SJ Leshin ◽  
LD Horwitz ◽  
JH Mitchell

The effects of acute severe aortic regurgitation on the left ventricle were investigated in conscious, chronically instrumented dogs. Left ventricular dimensions and volumes were measured from biplane cineradiographs of beads positioned near the endocardium. Data were collected before and after the production of aortic regurgitation by a catheter technique. The aortic regurgitation resulted in increases in mean aortic pulse pressure from 44 to 73 mmHg (P smaller than 0.001), heart rate from 87 to 122 beats/min (P smaller than 0.02), and left ventricular end-diastolic pressure from 11 to 25 mmHg (P smaller than 0.05). Mean end-diastolic volume rose from 61 to 69 cc (P smaller than 0.001), while end-systolic volume remained unchanged at 37 cc. The end-diastolic dilatation following regurgitation was asymmetrical in that the increase in size was due principally to an increase in the septal-lateral axis. The acute volume load of aortic regurgitation was accomplished by an increase in end-diastolic volume, i.e., the Frank-Starling mechanism. The tachycardia probably reflects augmented cardiac sympathetic activity, but the constant end-systolic volume at a similar mean systolic pressure suggests that the net contractile state was unchanged.


2000 ◽  
Vol 89 (1) ◽  
pp. 89-96 ◽  
Author(s):  
A. B. Johan Groeneveld ◽  
Remco R. Berendsen ◽  
Anton J. Schneider ◽  
Ioannis A. Pneumatikos ◽  
Leo A. Stokkel ◽  
...  

The purpose of this study was to evaluate right ventricular (RV) loading and cardiac output changes, by using the thermodilution technique, during the mechanical ventilatory cycle. Fifteen critically ill patients on mechanical ventilation, with 5 cmH2O of positive end-expiratory pressure, mean respiratory frequency of 18 breaths/min, and mean tidal volume of 708 ml, were studied with help of a rapid-response thermistor RV ejection fraction pulmonary artery catheter, allowing 5-ml room-temperature 5% isotonic dextrose thermodilution measurements of cardiac index (CI), stroke volume (SV) index, RV ejection fraction (RVEF), RV end-diastolic volume (RVEDV), and RV end-systolic volume (RVESV) indexes at 10% intervals of the mechanical ventilatory cycle. The ventilatory modulation of CI and RV volumes varied from patient to patient, and the interindividual variability was greater for the latter variables. Within patients also, RV volumes were modulated more by the ventilatory cycle than CI and SV index. Around a mean value of 3.95 ± 1.18 l · min−1 · m−2 (= 100%), CI varied from 87.3 ± 5.2 (minimum) to 114.3 ± 5.1% (maximum), and RVESV index varied between 61.5 ± 17.8 and 149.3 ± 34.1% of mean 55.1 ± 17.9 ml/m2 during the ventilatory cycle. The variations in the cycle exceeded the measurement error even though the latter was greater for RVEF and volumes than for CI and SV index. For mean values, there was an inspiratory decrease in RVEF and increase in RVESV, whereas a rise in RVEDV largely prevented a fall in SV index. We conclude that cyclic RV afterloading necessitates multiple thermodilution measurements equally spaced in the ventilatory cycle for reliable assessment of RV performance during mechanical ventilation of patients.


1993 ◽  
Vol 21 (3) ◽  
pp. 113-125
Author(s):  
O de Divitiis ◽  
M Galderisi ◽  
A Celentano ◽  
P Tammaro ◽  
M Garofalo ◽  
...  

The antihypertensive and haemodynamic efficacies of ketanserin and ketanserin plus enalapril were compared. The monotherapy phase of the study involved the oral administration of 40 mg ketanserin twice daily or 20 mg enalapril once daily for 12 weeks to 25 hypertensive patients. Systolic and diastolic blood pressures were significantly reduced by both drugs. Left ventricular function both at rest and during effort improved significantly with either drug. This was due to a reduction of end-systolic volume; end-diastolic volume decreased only with the use of enalapril. Combination therapy, involving 16 patients and both drugs given at the original dosage schedule for 12 weeks, resulted in further reductions in systolic and diastolic blood pressures, and an improvement in left ventricular function; indices of diastolic function were not modified. In conclusion, ketanserin and enalapril showed comparable antihypertensive and haemodynamic activities. A combination of ketanserin and enalapril increased the favourable characteristics of both drugs.


Sign in / Sign up

Export Citation Format

Share Document