Defining left ventricular apex-to-base twist mechanics computed from high-resolution 3D echocardiography: validation against sonomicrometry

Muhammad Ashraf; Andriy Myronenko; Thuan Nguyen; Akio Inage; Wayne Smith; Robert I Lowe; Karl Thiele; Carol A Gibbons Kroeker; John V Tyberg; Jeffrey F Smallhorn; David J Sahn; Xubo Song

doi:10.1016/j.jcmg.2009.09.027

Defining left ventricular apex-to-base twist mechanics computed from high-resolution 3D echocardiography: validation against sonomicrometry

JACC Cardiovasc Imaging. 2010 Mar;3(3):227-34. doi: 10.1016/j.jcmg.2009.09.027.

Authors

Muhammad Ashraf¹, Andriy Myronenko, Thuan Nguyen, Akio Inage, Wayne Smith, Robert I Lowe, Karl Thiele, Carol A Gibbons Kroeker, John V Tyberg, Jeffrey F Smallhorn, David J Sahn, Xubo Song

Affiliation

¹ Department of Pediatric Cardiology, Oregon Health & Science University, Portland, Oregon 97239-3098, USA.

PMID: 20223418
DOI: 10.1016/j.jcmg.2009.09.027

Abstract

Objectives: To compute left ventricular (LV) twist from 3-dimensional (3D) echocardiography.

Background: LV twist is a sensitive index of cardiac performance. Conventional 2-dimensional based methods of computing LV twist are cumbersome and subject to errors.

Methods: We studied 10 adult open-chest pigs. The pre-load to the heart was altered by temporary controlled occlusion of the inferior vena cava, and myocardial ischemia was produced by ligating the left anterior descending coronary artery. Full-volume 3D loops were reconstructed by stitching of pyramidal volumes acquired from 7 consecutive heart beats with electrocardiography gating on a Philips IE33 system (Philips Medical Systems, Andover, Massachusetts) at baseline and other steady states. Polar coordinate data of the 3D images were entered into an envelope detection program implemented in MatLab (The MathWorks, Inc., Natick, Massachusetts), and speckle motion was tracked using nonrigid image registration with spline-based transformation parameterization. The 3D displacement field was obtained, and rotation at apical and basal planes was computed. LV twist was derived as the net difference of apical and basal rotation. Sonomicrometry data of cardiac motion were also acquired from crystals anchored to epicardium in apical and basal planes at all states.

Results: The 3D dense tracking slightly overestimated the LV twist, but detected changes in LV twist at different states and showed good correlation (r = 0.89) when compared with sonomicrometry-derived twist at all steady states. In open chest pigs, peak cardiac twist was increased with reduction of pre-load from inferior vena cava occlusion from 6.25 degrees +/- 1.65 degrees to 9.45 degrees +/- 1.95 degrees . With myocardial ischemia from left anterior descending coronary artery ligation, twist was decreased to 4.90 degrees +/- 0.85 degrees (r = 0.8759).

Conclusions: Despite lower spatiotemporal resolution of 3D echocardiography, LV twist and torsion can be computed accurately.

Publication types

Comparative Study
Validation Study

MeSH terms

Animals
Disease Models, Animal
Echocardiography, Three-Dimensional*
Female
Heart Ventricles / diagnostic imaging*
Heart Ventricles / physiopathology
Image Interpretation, Computer-Assisted*
Male
Myocardial Ischemia / complications
Myocardial Ischemia / diagnostic imaging*
Myocardial Ischemia / physiopathology
Reproducibility of Results
Swine
Torsion, Mechanical
Ventricular Dysfunction, Left / diagnostic imaging*
Ventricular Dysfunction, Left / etiology
Ventricular Dysfunction, Left / physiopathology
Ventricular Function, Left*