Integrated backscatter for the assessment of myocardial viability

Yamada, Satoshi; Komuro, Kaoru

doi:10.1097/01.hco.0000240578.05053.f9

Cited by 8 publications

(7 citation statements)

References 27 publications

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“…Prior investigators using echocardiographic analyses of hypertensive disease have suggested that pathologic compared with non-pathologic changes within the LV wall can effectively change tissue impedances, thereby altering sonographic signals. Several studies have noted that cyclic variation in mean gray levels of integrated backscatter signals, which normally increase at end-diastole and decrease at end-systole, show less variation in the setting of hypertension and coronary disease [3], [5], [6], [23]. Tissue-level characteristics that influence ultrasonic backscatter are thought to include collagen content and fibrosis, tissue heterogeneity, fiber orientation, wall thickness, cell size, and sarcomere length [3]–[5], [22].…”

Section: Discussionmentioning

confidence: 99%

“…Investigators have hypothesized that these properties alter tissue impedances, thereby changing sonographic signal reflections and yielding signal intensity distributions that are unique to the scattering properties of the imaged LV wall. Thus, prior studies have used sonographic image analysis, including integrated backscatter techniques, to characterize myocardial tissue alterations in a variety of clinical settings, including hypertension,[5] early myocardial infarction,[6] chronic coronary artery disease,[7] and hypothyroidism [8], [9]. However, the use of previously established techniques has been limited by low sensitivity and specificity, particularly in the setting of poorer quality images [10].…”

Section: Introductionmentioning

confidence: 99%

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Identifying Early Changes in Myocardial Microstructure in Hypertensive Heart Disease

et al. 2014

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The transition from healthy myocardium to hypertensive heart disease is characterized by a series of poorly understood changes in myocardial tissue microstructure. Incremental alterations in the orientation and integrity of myocardial fibers can be assessed using advanced ultrasonic image analysis. We used a modified algorithm to investigate left ventricular myocardial microstructure based on analysis of the reflection intensity at the myocardial-pericardial interface on B-mode echocardiographic images. We evaluated the extent to which the novel algorithm can differentiate between normal myocardium and hypertensive heart disease in humans as well as in a mouse model of afterload resistance. The algorithm significantly differentiated between individuals with uncomplicated essential hypertension (N = 30) and healthy controls (N = 28), even after adjusting for age and sex (P = 0.025). There was a trend in higher relative wall thickness in hypertensive individuals compared to controls (P = 0.08), but no difference between groups in left ventricular mass (P = 0.98) or total wall thickness (P = 0.37). In mice, algorithm measurements (P = 0.026) compared with left ventricular mass (P = 0.053) more clearly differentiated between animal groups that underwent fixed aortic banding, temporary aortic banding, or sham procedure, on echocardiography at 7 weeks after surgery. Based on sonographic signal intensity analysis, a novel imaging algorithm provides an accessible, non-invasive measure that appears to differentiate normal left ventricular microstructure from myocardium exposed to chronic afterload stress. The algorithm may represent a particularly sensitive measure of the myocardial changes that occur early in the course of disease progression.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Identifying Early Changes in Myocardial Microstructure in Hypertensive Heart Disease

et al. 2014

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“…An analytic method that consistently distinguishes density changes throughout the cardiac cycle is believed to be sensitive to differences in myocardial density that occur in response to pathological processes. 1,6 Indeed, cyclical variability is observed upon application of the algorithm to consecutive frames within murine echocardiograms. A larger variation in intensity over the cardiac cycle is observed for imaging intensity values at higher compared to lower percentiles within the total signal intensity distribution.…”

Section: Discussionmentioning

confidence: 99%

“…Prior studies have suggested that measures of sonographic signal intensity can identify the underlying presence of myocardial fiber disarray, viable versus non-viable myocardial tissue, and interstitial fibrosis. 1–3 We refer to myocardial ‘microstructure’ as the tissue architecture that can be characterized, using sonographic analysis, beyond linear measurements of gross size and morphology. Accordingly, analyses of sonographic signal intensity have been used to evaluate microstructural alterations of myocardial tissue in the setting of hypertrophic and dilated cardiomyopathy, 4,5 chronic coronary artery disease, 6,7 and hypertensive heart disease.…”

Section: Introductionmentioning

confidence: 99%

Ultrasonic Assessment of Myocardial Microstructure

Hiremath

Bauer

Cheng

et al. 2014

JoVE

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Echocardiography is a widely accessible imaging modality that is commonly used to non-invasively characterize and quantify changes in cardiac structure and function. Ultrasonic assessments of cardiac tissue can include analyses of backscatter signal intensity within a given region of interest. Previously established techniques have relied predominantly on the integrated or mean value of backscatter signal intensities, which may be susceptible to variability from aliased data from low frame rates and time delays for algorithms based on cyclic variation. Herein, we describe an ultrasound-based imaging algorithm that extends from previous methods, can be applied to a single image frame, and accounts for the full distribution of signal intensity values derived from a given myocardial sample. When applied to representative mouse and human imaging data, the algorithm distinguishes between subjects with and without exposure to chronic afterload resistance. The algorithm offers an enhanced surrogate measure of myocardial microstructure and can be performed using open-access image analysis software.

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“…9,10 Even though accepted as a true and valid indicator of myocardial ischemia, it had rarely been accepted in clinical applications. 11,12 Lately in some papers, IBS is used for the detection of fibrosis in order to make the association with arrhythmia. 13 Today, IBS is still used with IVUS for tissue characterization in coronary artery disease.…”

Section: Introductionmentioning

confidence: 99%

Association between integrated backscatter and arrhythmia in patients with ischemic dilated cardiomyopathy

Karaayvaz

Engin

Yalın

et al. 2021

Pacing Clinical Electrophis

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Background Ventricular scars due to myocardial infarction provide a substrate for ventricular arrhythmias, and cardiac magnetic resonance (CMR) is the golden standard for the quantification of scar tissue magnitude. CMR has still limitations with patients with ICD despite ICD's becoming MR‐compatible. We investigated the association between calibrated integrated backscatter (cIBS) and arrhythmia frequency in patients with ICD. Methods Thirty‐two ischemic dilated cardiomyopathy (ICM) patients with VVI‐ICD (mean age 66.56 ± 9.05, 28 male, and four female) were divided into three groups according to their arrhythmia frequency (ventricular arrhythmia—[VA ‐], VA + [VA +], and arrhythmia storm [AS]). Then with transthoracic echocardiography (TTE), all patients’ cIBS values were calculated and these values were compared with the patients’ arrhythmia frequency. Results cIBS values of patients with VA + and AS were significantly higher in the apical‐septal (0.66 ± 0.11 vs. 0.50 ± 0.16, p = .008) and apical‐lateral (0.62 ± 0.19 vs. 0.46 ± 0.18, p = .041) segments compared to those of patients with VA ‐. The cIBS values of apical‐septal (0.50 ± 0.16 vs. 0.65 ± 0.08 vs. 0.66 ± 0.13 respectively, p = .032) and apical‐anterior (0.53 ± 0.22 vs. 0.48 ± 0.17 vs. 0.79 ± 0.23 respectively, p = .03) segments were significantly different between the groups. Furthermore, in the post hoc analysis, the difference was significantly higher in VA + than VA ‐ in the apical‐septal segment and higher in AS than VA + in apical‐anterior segments. Conclusion Our findings suggest an association between the cIBS values and arrhythmia frequency in the study group.

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Integrated backscatter for the assessment of myocardial viability

Abstract: Ultrasonic tissue characterization with integrated backscatter is a useful non-invasive method that can provide unique information for the assessment of myocardial viability.

Cited by 8 publications

References 27 publications

Identifying Early Changes in Myocardial Microstructure in Hypertensive Heart Disease

Identifying Early Changes in Myocardial Microstructure in Hypertensive Heart Disease

Ultrasonic Assessment of Myocardial Microstructure

Association between integrated backscatter and arrhythmia in patients with ischemic dilated cardiomyopathy

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