| 1. |
- Binka, Edem, et al.
(author)
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Biventricular Pressure-Volume Loop Assessment Before and After Pulmonary Valve Replacement in Tetralogy of Fallot
- 2022
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In: Journal of Thoracic Imaging. - 0883-5993. ; 37:5, s. 70-71
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Journal article (peer-reviewed)abstract
- Patients with tetralogy of Fallot (TOF) may undergo pulmonary valve replacement (PVR) after initial full repair. We investigated indices of biventricular function, work and efficiency of TOF patients' using noninvasive pressure-volume (PV) loop analysis on cardiovascular magnetic resonance (CMR) images and compared pre-and post PVR groups. Biventricular segmentations of steady state free precession CMR images were performed using custom validated software (Segment version 2.0 R7067). Brachial cuff pressure estimated left ventricular (LV) systolic pressure. Right ventricular (RV) inputs were obtained from pre-PVR cardiac catheterization data. Biventricular PV loops were then derived using a time-varying elastance model. Twenty seven patients were studied: (22 pre-PVR, 5 post-PVR), mean age of 20±10.5 years and 83% male. RV stroke volume significantly differed before and after PVR (73.2±25 ml vs. 41±10 mL, P=0.01). RV stroke work (SW) and mean external power (MEP) were significantly less post-PVR, but there were no significant differences in the LV hemodynamic indices. TOF patients have reduced RV SW and MEP post-PVR suggesting improved hemodynamics. Noninvasive biventricular PV loop analysis shows potential for integration into standard CMR imaging of TOF and provides hemodynamic data that could influence management decisions.
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| 2. |
- Gonzales, Ricardo A., et al.
(author)
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Automated Measurements of Mitral and Tricuspid Annular Dimensions in Cardiovascular Magnetic Resonance
- 2022
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In: ISBI 2022 - Proceedings : 2022 IEEE International Symposium on Biomedical Imaging - 2022 IEEE International Symposium on Biomedical Imaging. - 1945-7928 .- 1945-8452. - 9781665429238 ; 2022-March
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Conference paper (peer-reviewed)abstract
- Our recent work on mitral and tricuspid valve tracking in cardiovascular magnetic resonance (CMR) imaging to obtain accurate evaluations of longitudinal myocardial valve motion (both relaxation and contraction) has enabled an automated diastolic function assessment (e') with CMR. Its time-resolved capability allows a further evaluation of the valve dynamics by providing valve dimension measurements, which are essential to define the etiologies and mechanisms of valve regurgitation. In this paper, we extended the framework to automatically measure mitral annular (MA) and tricuspid annular (TA) dimensions in CMR long-axis cines with a residual neural network backbone. The framework is able to measure MA and TA diameters with an overall excellent accuracy (mean ICC=0.92), on par with an evaluated inter-observer variability (mean ICC=0.92), and to distinguish valvular dimensions between healthy controls and patients with chronic heart failure (p<0.001). Dimension measurements may benefit patients requiring annular sizing and planning of valvular interventions.
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| 3. |
- Lindholm, Anthony, et al.
(author)
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Atrioventricular plane displacement and regional function to predict outcome in pulmonary arterial hypertension
- 2022
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In: International Journal of Cardiovascular Imaging. - : Springer Science and Business Media LLC. - 1875-8312 .- 1573-0743. ; 38:10, s. 2235-2248
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Journal article (peer-reviewed)abstract
- To investigate if left and right atrioventricular plane displacement (AVPD) or regional contributions to SV are prognostic for outcome in patients with pulmonary arterial hypertension (PAH). Seventy-one patients with PAH and 20 sex- and age-matched healthy controls underwent CMR. Myocardial borders and RV insertion points were defined at end diastole and end systole in cine short-axis stacks to compute biventricular volumes, lateral (SVlat%) and septal (SVsept%) contribution to stroke volume. Eight atrioventricular points were defined at end diastole and end systole in 2-, 3- and 4-chamber cine long-axis views for computation of AVPD and longitudinal contribution to stroke volume (SVlong%). Cut-off values for survival analysis were defined as two standard deviations above or below the mean of the controls. Outcome was defined as death or lung transplantation. Median follow-up time was 3.6 [IQR 3.7] years. Patients were 57 ± 19 years (65% women) and controls 58 ± 15 years (70% women). Biventricular AVPD, SVlong% and ejection fraction (EF) were lower and SVlat% was higher, while SVsept% was lower in PAH compared with controls. In PAH, transplantation-free survival was lower below cut-off for LV-AVPD (hazard ratio [HR] = 2.1, 95%CI 1.2–3.9, p = 0.02) and RV-AVPD (HR = 9.8, 95%CI 4.6–21.1, p = 0.005). In Cox regression analysis, lower LV-AVPD and RV-AVPD inferred lower transplantation-free survival (LV: HR = 1.16, p = 0.007; RV: HR = 1.11, p = 0.01; per mm decrease). LV-SVlong%, RV-SVlong%, LV-SVlat%, RV-SVlat%, SVsept% and LV- and RVEF did not affect outcome. Low left and right AVPD were associated with outcome in PAH, but regional contributions to stroke volume and EF were not.
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