Two-dimensional ultrasonic tissue characterization: backscatter power, endocardial wall motion, and their phase relationship for normal, ischemic, and infarcted myocardium.

Fitzgerald, Peter J.; McDaniel, Martha D.; Rolett, Ellis L.; Strohbehn, John W.; James, Douglas H.

doi:10.1161/01.cir.76.4.850

Cited by 81 publications

(13 citation statements)

References 46 publications

(19 reference statements)

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“…This hypothesis is supported by several experimental studies, [18][19][20][21][22] wherein this parameter has been demonstrated to decrease with myocardial ischemia19,22 and infarction.21,22 As opposed to measurement of absolute IB, the variation in IB in humans is obtainable with a current system because it does not require any calibration of ultrasound signals and subsequent standardization among subjects. Thus, cardiac cycle-dependent variation of IB can be used to assess alterations in the acoustic properties of the myocardium even in humans.…”

Section: Discussionmentioning

confidence: 78%

Ultrasonic tissue characterization of human hypertrophied hearts in vivo with cardiac cycle-dependent variation in integrated backscatter.

et al. 1989

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Integrated ultrasonic backscatter (IB) is a noninvasive measure of the acoustic properties of myocardium. Previous experimental studies have indicated that altered acoustic properties of the myocardium are reflected by the magnitude of variation of IB during the cardiac cycle. In our study, cardiac cycle-dependent variation of IB was noninvasively measured using a quantitative IB imaging system in 12 patients with uncomplicated pressure-overload hypertrophy and 13 patients with hypertrophic cardiomyopathy. Sixteen normal subjects served as a control. The magnitude of cardiac cycle-dependent variation of IB for the posterior wall was 6.0± 0.9 dB in normal subjects, 5.7±+0.8 dB in the patients with uncomplicated pressureoverload hypertrophy, and 6.7+±2.1 dB in the patients with hypertrophic cardiomyopathy. There were no significant differences among any of these groups. In contrast, the magnitude of cardiac cycle-dependent variation of IB for the septum was significantly smaller in the patients with uncomplicated pressure-overload hypertrophy (2.8+1.3 dB) and in the patients with hypertrophic cardiomyopathy (3.1±2.3 dB) than in normal subjects (4.9±1.0 dB). The magnitude of cardiac cycle-dependent variation of IB was smaller as the wall-thickness index increased (r=-0.53, p<0.01, n=82 for all data). This IB measure also correlated with percent-systolic thickening of the myocardium (r=0.67,p<0.01, n=82). Thus, alteration in the magnitude of cardiac cycle-dependent variation of IB was observed in hypertrophic hearts and showed apparent regional myocardial differences. (Circulation 1989;80:925-934) L eft ventricular hypertrophy is a common adaptation mechanism in patients with pressure overload such as hypertension and aortic stenosis.1,2 Idiopathic left ventricular hypertrophy also may occur and this is usually classified as hypertrophic cardiomyopathy (HCM).3 HCM, in most cases, is characterized by asymmetric septal hypertrophy,4-8 and, thus, M-mode and twodimensional echocardiography are useful both in the quantification of hypertrophy and in the differentiation of these two forms of hypertrophy.

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Section: Discussionmentioning

confidence: 78%

Ultrasonic tissue characterization of human hypertrophied hearts in vivo with cardiac cycle-dependent variation in integrated backscatter.

et al. 1989

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“…Certain statistical signal features have enabled investigators to distinguish among different types of tissue structure (25,26). For example, normal versus infarcted myocardium can be distinguished by integrated backscatter measurements (27) as well as their particular probability distribution functions (28). However, clinical utility has been limited because of several inherent problems, such as low frequency in order to gain penetration, motion artifacts caused by myocardial contraction and intervening tissue structure, and tissue anisotropy.…”

Section: Tissue Characterizationmentioning

confidence: 99%

<title>Potential for tissue characterization of plaque and arterial wall using intravascular ultrasound</title>

1993

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“…Certain statistical signal features have enabled investigators to distinguish between different types of tissue structure.34,35 For example, normal vs. infarcted myocardium can be distinguished by integrated backscatter measurements,36 as well as their particular probability distribution functions. 37 However, clinical utility has been limited because of several inherent problems. The use of low frequency to gain penetration has limited resolving capabilities of the tissue characterization techniques.…”

Section: Clinical Applicationsmentioning

confidence: 99%

Catheter-Tipped Ultrasonic Intravascular Imaging

Fitzgerald¹,

Yock²,

Ring³

1989

Perspectives in Vascular Surgery and Endovascular Therapy

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New methods for vascular recanalization such as balloon angioplasty, 1,2 transluminal atherectomy,3,4 and laser ablation5~6 have emerged over the past 10 years as alternatives to bypass surgery. These methods are designed to deal with specific morphologic characteristics of atheromatous lesions that are generally not apparent on angiogram. Despite several new advances in the area of contrast imaging such as improved signal-to-noise levels, postprocessing techniques, and real-time digital subtraction angiography,' angiography is limited as a guidance modality for interventional therapy in complex lesions. For example, the success of angioplasty depends on the composition and relative compliance of the lesion and the normal vessel wall. Angiograms provide information about the location of the critical narrowing and relative degree of stenosis but add little information concerning the likelihood of successful dilation vs. significant dissection. Several studies8,9 have documented the fairly limited sensitivity and specificity of angiographic data compared with surgical or pathologic data. Epicardial ultrasound has shown that the atherosclerotic process is diffuse rather than localized as depicted by angiograms. 10 Postmortem studiesll show that nearly 75% of all atherosclerotic lesions are eccentric. Asymmetric lesions may account in part for the difficulty in accurately predicting the degree and extent of stenosis based on angiography.The shape of the lesion is especially important when considering interventional therapy that depends on the spatial orientation of the stenotic region. Transluminal atherectomy devices are now emerging in the clinical arena. 12 The Simpson Atherocath makes use of a fine cutting edge mounted within a housing element at the tip of a catheter to &dquo;shave&dquo; off the atheromatous lesion. Perforation is a potentially critical complication of these devices 13; therefore precise orientation of the cutting blade and knowledge about the characteristics of the lesion are desired. Angiograms help in the positioning of the atherectomy at UNIV TORONTO on June 5, 2016 pvs.sagepub.com Downloaded from

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Two-dimensional ultrasonic tissue characterization: backscatter power, endocardial wall motion, and their phase relationship for normal, ischemic, and infarcted myocardium.

Cited by 81 publications

References 46 publications

Ultrasonic tissue characterization of human hypertrophied hearts in vivo with cardiac cycle-dependent variation in integrated backscatter.

Ultrasonic tissue characterization of human hypertrophied hearts in vivo with cardiac cycle-dependent variation in integrated backscatter.

<title>Potential for tissue characterization of plaque and arterial wall using intravascular ultrasound</title>

Catheter-Tipped Ultrasonic Intravascular Imaging

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