Cardiac fluid dynamics meets deformation imaging

Ferro, Matteo Dal; Stolfo, Davide; Paris, Valerio De; Lesizza, Pierluigi; Korcova, Renata; Collia, Dario; Tonti, Giovanni; Sinagra, Gianfranco; Pedrizzetti, Gianni

doi:10.1186/s12947-018-0122-2

Cited by 9 publications

(7 citation statements)

References 51 publications

(55 reference statements)

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“…The LV 2D strain was quantified using commercially available software (2DCPA v.1.3; TomTec Imaging Systems Gmbh, Unterschleissheim, Germany). We performed analyses in all three apical views (LV four-chambers, twochambers, and three-chambers) and the most suitable cardiac cycle [8]. The software required to draw the end-systolic endocardial and epicardial borders and track them over the entire heartbeat; subsequently, it allowed us to correct the end-diastolic borders and to propagate the correction over the entire cardiac cycle without affecting the previously drawn end-systolic borders.…”

Section: D Lv Speckle Tracking Image Analysismentioning

confidence: 99%

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A new integrated approach to cardiac mechanics: reference values for normal left ventricle

Faganello

Collia

Furlotti

et al. 2020

Int J Cardiovasc Imaging

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The association between left ventricular (LV) myocardial deformation and hemodynamic forces is still mostly unexplored. The normative values and the effects of demographic and technical factors on hemodynamic forces are not known. The authors studied the association between LV myocardial deformation and hemodynamic forces in a large cohort of healthy volunteers. One-hundred seventy-six consecutive subjects (age range, 16-82; 51% women), with no cardiovascular risk factors or any relevant diseases, were enrolled. All subjects underwent an echo-Doppler examination. Both 2D global myocardial and endocardial longitudinal strain (GLS), circumferential strain (GCS), and the hemodynamic forces were measured with new software that enabled to calculate all these values and parameters from the three apical views. Higher LV mass index and larger LV volumes were found in males compared to females (85 ± 17 vs 74 ± 15 g/m 2 and 127 ± 28 vs 85 ± 18 ml, p < 0.0001 respectively) while no differences of the mean values of endocardial and myocardial GLS and of myocardial GCS were found (p = ns) and higher endocardial GCS in women (

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Section: D Lv Speckle Tracking Image Analysismentioning

confidence: 99%

“…Longitudinal and circumferential strain actively contributes to the LV volumetric reduction during the systole and so to the ejection fraction. We recently provided a mathematical model relating to LVEF and strain [4,8].…”

Section: Relationship Between Deformation Imaging and Lvefmentioning

confidence: 99%

A new integrated approach to cardiac mechanics: reference values for normal left ventricle

Faganello

Collia

Furlotti

et al. 2020

Int J Cardiovasc Imaging

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“…Non-invasive, speckle-tracking Doppler echocardiography has been employed to evaluate LA mechanical function via myocardial strain ( 36 , 37 ). This metric measures the contractility/deformation of the LA wall, which is severely impaired during AF and directly influences intracardiac blood motion, potentially leading to stasis ( 38 ).…”

Section: Cardiac Imaging For Af and Stroke Riskmentioning

confidence: 99%

Imaging and biophysical modelling of thrombogenic mechanisms in atrial fibrillation and stroke

Qureshi

Lip

Nordsletten

et al. 2023

Front. Cardiovasc. Med.

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Atrial fibrillation (AF) underlies almost one third of all ischaemic strokes, with the left atrial appendage (LAA) identified as the primary thromboembolic source. Current stroke risk stratification approaches, such as the CHA2DS2-VASc score, rely mostly on clinical comorbidities, rather than thrombogenic mechanisms such as blood stasis, hypercoagulability and endothelial dysfunction—known as Virchow’s triad. While detection of AF-related thrombi is possible using established cardiac imaging techniques, such as transoesophageal echocardiography, there is a growing need to reliably assess AF-patient thrombogenicity prior to thrombus formation. Over the past decade, cardiac imaging and image-based biophysical modelling have emerged as powerful tools for reproducing the mechanisms of thrombogenesis. Clinical imaging modalities such as cardiac computed tomography, magnetic resonance and echocardiographic techniques can measure blood flow velocities and identify LA fibrosis (an indicator of endothelial dysfunction), but imaging remains limited in its ability to assess blood coagulation dynamics. In-silico cardiac modelling tools—such as computational fluid dynamics for blood flow, reaction-diffusion-convection equations to mimic the coagulation cascade, and surrogate flow metrics associated with endothelial damage—have grown in prevalence and advanced mechanistic understanding of thrombogenesis. However, neither technique alone can fully elucidate thrombogenicity in AF. In future, combining cardiac imaging with in-silico modelling and integrating machine learning approaches for rapid results directly from imaging data will require development under a rigorous framework of verification and clinical validation, but may pave the way towards enhanced personalised stroke risk stratification in the growing population of AF patients. This Review will focus on the significant progress in these fields.

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“…However, MRI flow imaging present a certain operational complexity and costs resulting feasible only among limited populations [37]. The availability of HDFs quantification based on STE technology allows more extensive clinical evaluations [38].…”

Section: Previous Studiesmentioning

confidence: 99%

Reference Ranges of Left Ventricular Hemodynamic Forces in Healthy Adults: A Speckle-Tracking Echocardiographic Study

Ferrara

Capuano

Cocchia³

et al. 2021

JCM

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Background: The normal limits of left ventricular (LV) hemodynamic forces (HDFs) are not exactly known. The aim of this study was to explore the full spectrum of HDF parameters in healthy subjects and determine their physiologic correlates. Methods: 269 healthy subjects were enrolled (mean age: 43 ± 14 years; 123 (45.7%) men). All participants underwent an echo-Doppler examination. Tri-plane tissue tracking from apical views was used to measure 2D global endocardial longitudinal strain (GLS), circumferential strain (GCS), and LV HDFs. HDFs were normalized with LV volume and divided by specific weight. Results: LV systolic longitudinal HDFs (%) were higher in men (20.8 ± 6.5 vs. 18.9 ± 5.6, p = 0.009; 22.0 ± 6.7 vs. 19.8 ± 5.6, p = 0.004, respectively). There was a significant correlation between GCS (increased) (r = −0.240, p < 0.001) and LV longitudinal HDFs (reduced) (r = −0.155, p = 0.01) with age. In a multivariable analysis age, BSA, pulse pressure, heart rate and GCS were the only independent variables associated with LV HDFs (β coefficient = −0.232, p < 0.001; 0.149, p = 0.003; 0.186, p < 0.001; 0.396, p < 0.001; −0.328, p < 0.001; respectively). Conclusion: We report on the physiologic range of LV HDFs. Knowledge of reference values of HDFs may prompt their implementation into clinical routine and allow a more comprehensive assessment of the LV function.

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Cardiac fluid dynamics meets deformation imaging

Cited by 9 publications

References 51 publications

A new integrated approach to cardiac mechanics: reference values for normal left ventricle

A new integrated approach to cardiac mechanics: reference values for normal left ventricle

Imaging and biophysical modelling of thrombogenic mechanisms in atrial fibrillation and stroke

Reference Ranges of Left Ventricular Hemodynamic Forces in Healthy Adults: A Speckle-Tracking Echocardiographic Study

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