The Experts below are selected from a list of 7917 Experts worldwide ranked by ideXlab platform
Nowell M Fine - One of the best experts on this subject based on the ideXlab platform.
-
characterization of right ventricular deformation in pulmonary arterial hypertension using three dimensional Principal Strain analysis
Journal of The American Society of Echocardiography, 2019Co-Authors: Alessandro Satriano, Payam Pournazari, Naushad Hirani, Doug Helmersen, Mitesh V Thakrar, Jason Weatherald, James A White, Nowell M FineAbstract:Background Pulmonary arterial hypertension (PAH) can cause maladaptive right ventricular (RV) functional changes associated with adverse prognosis that are challenging to accurately quantify noninvasively. The aim of this study was to explore Principal Strain (PS) with contraction angle analysis using three-dimensional echocardiography to characterize RV deformation changes in patients with PAH. Methods Three-dimensional echocardiography was performed in 37 patients with PAH and 20 healthy control subjects with two-component (primary and secondary) PS and Principal contraction angle analysis. Patients were stratified according to World Health Organization (WHO) functional class. Results Primary PS differed significantly between patients with PAH and healthy control subjects (−20.2 ± 3.3% vs −26.8 ± 3.3%, P = .01), while secondary PS was not significantly different (3.6 ± 5.1% vs −2.5 ± 4.7%, P = .12). Principal contraction angle was significantly lower in patients with PAH (63 ± 22° vs 71 ± 7°, P = .01), with the greatest reduction for the RV free wall. Primary PS and Principal contraction angle differed significantly between WHO class I and II and class III and IV patients (−23.9 ± 4.7% vs −18.1 ± 4.8% [P = .03] and 69 ± 9° vs 58 ± 14° [P = .03], respectively), while secondary PS was not significantly different between groups (P = .13). Compared with healthy control subjects, septal Principal contraction angle was not different in patients with WHO class I and II PAH (P = .62), but it was significantly reduced in those with WHO class III and IV PAH (P Conclusions PS analysis using three-dimensional echocardiography provides comprehensive quantification of RV deformation and characterizes alterations occurring in PAH that are associated with WHO functional class.
-
Three-dimensional thoracic aorta Principal Strain analysis from routine ECG-gated computerized tomography: feasibility in patients undergoing transcatheter aortic valve replacement
BMC Cardiovascular Disorders, 2018Co-Authors: Alessandro Satriano, Carmen P Lydell, James A White, Zachary Guenther, Naeem Merchant, Elena S. Di Martino, Faisal Al-qoofi, Nowell M FineAbstract:Functional impairment of the aorta is a recognized complication of aortic and aortic valve disease. Aortic Strain measurement provides effective quantification of mechanical aortic function, and 3-dimenional (3D) approaches may be desirable for serial evaluation. Computerized tomographic angiography (CTA) is routinely performed for various clinical indications, and offers the unique potential to study 3D aortic deformation. We sought to investigate the feasibility of performing 3D aortic Strain analysis in a candidate population of patients undergoing transcatheter aortic valve replacement (TAVR). Twenty-one patients with severe aortic valve stenosis (AS) referred for TAVR underwent ECG-gated CTA and echocardiography. CTA images were analyzed using a 3D feature-tracking based technique to construct a dynamic aortic mesh model to perform peak Principal Strain amplitude (PPSA) analysis. Segmental Strain values were correlated against clinical, hemodynamic and echocardiographic variables. Reproducibility analysis was performed. The mean patient age was 81±6 years. Mean left ventricular ejection fraction was 52±14%, aortic valve area (AVA) 0.6±0.3 cm2 and mean AS pressure gradient (MG) 44±11 mmHg. CTA-based 3D PPSA analysis was feasible in all subjects. Mean PPSA values for the global thoracic aorta, ascending aorta, aortic arch and descending aorta segments were 6.5±3.0, 10.2±6.0, 6.1±2.9 and 3.3±1.7%, respectively. 3D PSSA values demonstrated significantly more impairment with measures of worsening AS severity, including AVA and MG for the global thoracic aorta and ascending segment (p
-
three dimensional thoracic aorta Principal Strain analysis from routine ecg gated computerized tomography feasibility in patients undergoing transcatheter aortic valve replacement
BMC Cardiovascular Disorders, 2018Co-Authors: Alessandro Satriano, Carmen P Lydell, James A White, Zachary Guenther, Naeem Merchant, Elena S. Di Martino, Faisal Alqoofi, Nowell M FineAbstract:Functional impairment of the aorta is a recognized complication of aortic and aortic valve disease. Aortic Strain measurement provides effective quantification of mechanical aortic function, and 3-dimenional (3D) approaches may be desirable for serial evaluation. Computerized tomographic angiography (CTA) is routinely performed for various clinical indications, and offers the unique potential to study 3D aortic deformation. We sought to investigate the feasibility of performing 3D aortic Strain analysis in a candidate population of patients undergoing transcatheter aortic valve replacement (TAVR). Twenty-one patients with severe aortic valve stenosis (AS) referred for TAVR underwent ECG-gated CTA and echocardiography. CTA images were analyzed using a 3D feature-tracking based technique to construct a dynamic aortic mesh model to perform peak Principal Strain amplitude (PPSA) analysis. Segmental Strain values were correlated against clinical, hemodynamic and echocardiographic variables. Reproducibility analysis was performed. The mean patient age was 81±6 years. Mean left ventricular ejection fraction was 52±14%, aortic valve area (AVA) 0.6±0.3 cm2 and mean AS pressure gradient (MG) 44±11 mmHg. CTA-based 3D PPSA analysis was feasible in all subjects. Mean PPSA values for the global thoracic aorta, ascending aorta, aortic arch and descending aorta segments were 6.5±3.0, 10.2±6.0, 6.1±2.9 and 3.3±1.7%, respectively. 3D PSSA values demonstrated significantly more impairment with measures of worsening AS severity, including AVA and MG for the global thoracic aorta and ascending segment (p<0.001 for all). 3D PSSA was independently associated with AVA by multivariable modelling. Coefficients of variation for intra- and inter-observer variability were 5.8 and 7.2%, respectively. Three-dimensional aortic PPSA analysis is clinically feasible from routine ECG-gated CTA. Appropriate reductions in PSSA were identified with increasing AS hemodynamic severity. Expanded study of 3D aortic PSSA for patients with various forms of aortic disease is warranted.
-
clinical feasibility and validation of 3d Principal Strain analysis from cine mri comparison to 2d Strain by mri and 3d speckle tracking echocardiography
International Journal of Cardiovascular Imaging, 2017Co-Authors: Alessandro Satriano, Bobak Heydari, Mariam Narous, Derek V Exner, Yoko Mikami, Monica M Attwood, John V Tyberg, Carmen P Lydell, Andrew G Howarth, Nowell M FineAbstract:Two-dimensional (2D) Strain analysis is conStrained by geometry-dependent reference directions of deformation (i.e. radial, circumferential, and longitudinal) following the assumption of cylindrical chamber architecture. Three-dimensional (3D) Principal Strain analysis may overcome such limitations by referencing intrinsic (i.e. Principal) directions of deformation. This study aimed to demonstrate clinical feasibility of 3D Principal Strain analysis from routine 2D cine MRI with validation to Strain from 2D tagged cine analysis and 3D speckle tracking echocardiography. Thirty-one patients undergoing cardiac MRI were studied. 3D Strain was measured from routine, multi-planar 2D cine SSFP images using custom software designed to apply 4D deformation fields to 3D cardiac models to derive Principal Strain. Comparisons of Strain estimates versus those by 2D tagged cine, 2D non-tagged cine (feature tracking), and 3D speckle tracking echocardiography (STE) were performed. Mean age was 51 ± 14 (36% female). Mean LV ejection fraction was 66 ± 10% (range 37–80%). 3D Principal Strain analysis was feasible in all subjects and showed high inter- and intra-observer reproducibility (ICC range 0.83–0.97 and 0.83–0.98, respectively—p < 0.001 for all directions). Strong correlations of minimum and maximum Principal Strain were respectively observed versus the following: 3D STE estimates of longitudinal (r = 0.81 and r = −0.64), circumferential (r = 0.76 and r = −0.58) and radial (r = −0.80 and r = 0.63) Strain (p < 0.001 for all); 2D tagged cine estimates of longitudinal (r = 0.81 and r = −0.81), circumferential (r = 0.87 and r = −0.85), and radial (r = −0.76 and r = 0.81) Strain (p < 0.0001 for all); and 2D cine (feature tracking) estimates of longitudinal (r = 0.85 and −0.83), circumferential (r = 0.88 and r = −0.87), and radial Strain (r = −0.79 and r = 0.84, p < 0.0001 for all). 3D Principal Strain analysis is feasible using routine, multi-planar 2D cine MRI and shows high reproducibility with strong correlations to 2D conventional Strain analysis and 3D STE-based analysis. Given its independence from geometry-related directions of deformation this technique may offer unique benefit for the detection and prognostication of myocardial disease, and warrants expanded investigation.
Alessandro Satriano - One of the best experts on this subject based on the ideXlab platform.
-
characterization of right ventricular deformation in pulmonary arterial hypertension using three dimensional Principal Strain analysis
Journal of The American Society of Echocardiography, 2019Co-Authors: Alessandro Satriano, Payam Pournazari, Naushad Hirani, Doug Helmersen, Mitesh V Thakrar, Jason Weatherald, James A White, Nowell M FineAbstract:Background Pulmonary arterial hypertension (PAH) can cause maladaptive right ventricular (RV) functional changes associated with adverse prognosis that are challenging to accurately quantify noninvasively. The aim of this study was to explore Principal Strain (PS) with contraction angle analysis using three-dimensional echocardiography to characterize RV deformation changes in patients with PAH. Methods Three-dimensional echocardiography was performed in 37 patients with PAH and 20 healthy control subjects with two-component (primary and secondary) PS and Principal contraction angle analysis. Patients were stratified according to World Health Organization (WHO) functional class. Results Primary PS differed significantly between patients with PAH and healthy control subjects (−20.2 ± 3.3% vs −26.8 ± 3.3%, P = .01), while secondary PS was not significantly different (3.6 ± 5.1% vs −2.5 ± 4.7%, P = .12). Principal contraction angle was significantly lower in patients with PAH (63 ± 22° vs 71 ± 7°, P = .01), with the greatest reduction for the RV free wall. Primary PS and Principal contraction angle differed significantly between WHO class I and II and class III and IV patients (−23.9 ± 4.7% vs −18.1 ± 4.8% [P = .03] and 69 ± 9° vs 58 ± 14° [P = .03], respectively), while secondary PS was not significantly different between groups (P = .13). Compared with healthy control subjects, septal Principal contraction angle was not different in patients with WHO class I and II PAH (P = .62), but it was significantly reduced in those with WHO class III and IV PAH (P Conclusions PS analysis using three-dimensional echocardiography provides comprehensive quantification of RV deformation and characterizes alterations occurring in PAH that are associated with WHO functional class.
-
Three-dimensional thoracic aorta Principal Strain analysis from routine ECG-gated computerized tomography: feasibility in patients undergoing transcatheter aortic valve replacement
BMC Cardiovascular Disorders, 2018Co-Authors: Alessandro Satriano, Carmen P Lydell, James A White, Zachary Guenther, Naeem Merchant, Elena S. Di Martino, Faisal Al-qoofi, Nowell M FineAbstract:Functional impairment of the aorta is a recognized complication of aortic and aortic valve disease. Aortic Strain measurement provides effective quantification of mechanical aortic function, and 3-dimenional (3D) approaches may be desirable for serial evaluation. Computerized tomographic angiography (CTA) is routinely performed for various clinical indications, and offers the unique potential to study 3D aortic deformation. We sought to investigate the feasibility of performing 3D aortic Strain analysis in a candidate population of patients undergoing transcatheter aortic valve replacement (TAVR). Twenty-one patients with severe aortic valve stenosis (AS) referred for TAVR underwent ECG-gated CTA and echocardiography. CTA images were analyzed using a 3D feature-tracking based technique to construct a dynamic aortic mesh model to perform peak Principal Strain amplitude (PPSA) analysis. Segmental Strain values were correlated against clinical, hemodynamic and echocardiographic variables. Reproducibility analysis was performed. The mean patient age was 81±6 years. Mean left ventricular ejection fraction was 52±14%, aortic valve area (AVA) 0.6±0.3 cm2 and mean AS pressure gradient (MG) 44±11 mmHg. CTA-based 3D PPSA analysis was feasible in all subjects. Mean PPSA values for the global thoracic aorta, ascending aorta, aortic arch and descending aorta segments were 6.5±3.0, 10.2±6.0, 6.1±2.9 and 3.3±1.7%, respectively. 3D PSSA values demonstrated significantly more impairment with measures of worsening AS severity, including AVA and MG for the global thoracic aorta and ascending segment (p
-
three dimensional thoracic aorta Principal Strain analysis from routine ecg gated computerized tomography feasibility in patients undergoing transcatheter aortic valve replacement
BMC Cardiovascular Disorders, 2018Co-Authors: Alessandro Satriano, Carmen P Lydell, James A White, Zachary Guenther, Naeem Merchant, Elena S. Di Martino, Faisal Alqoofi, Nowell M FineAbstract:Functional impairment of the aorta is a recognized complication of aortic and aortic valve disease. Aortic Strain measurement provides effective quantification of mechanical aortic function, and 3-dimenional (3D) approaches may be desirable for serial evaluation. Computerized tomographic angiography (CTA) is routinely performed for various clinical indications, and offers the unique potential to study 3D aortic deformation. We sought to investigate the feasibility of performing 3D aortic Strain analysis in a candidate population of patients undergoing transcatheter aortic valve replacement (TAVR). Twenty-one patients with severe aortic valve stenosis (AS) referred for TAVR underwent ECG-gated CTA and echocardiography. CTA images were analyzed using a 3D feature-tracking based technique to construct a dynamic aortic mesh model to perform peak Principal Strain amplitude (PPSA) analysis. Segmental Strain values were correlated against clinical, hemodynamic and echocardiographic variables. Reproducibility analysis was performed. The mean patient age was 81±6 years. Mean left ventricular ejection fraction was 52±14%, aortic valve area (AVA) 0.6±0.3 cm2 and mean AS pressure gradient (MG) 44±11 mmHg. CTA-based 3D PPSA analysis was feasible in all subjects. Mean PPSA values for the global thoracic aorta, ascending aorta, aortic arch and descending aorta segments were 6.5±3.0, 10.2±6.0, 6.1±2.9 and 3.3±1.7%, respectively. 3D PSSA values demonstrated significantly more impairment with measures of worsening AS severity, including AVA and MG for the global thoracic aorta and ascending segment (p<0.001 for all). 3D PSSA was independently associated with AVA by multivariable modelling. Coefficients of variation for intra- and inter-observer variability were 5.8 and 7.2%, respectively. Three-dimensional aortic PPSA analysis is clinically feasible from routine ECG-gated CTA. Appropriate reductions in PSSA were identified with increasing AS hemodynamic severity. Expanded study of 3D aortic PSSA for patients with various forms of aortic disease is warranted.
-
clinical feasibility and validation of 3d Principal Strain analysis from cine mri comparison to 2d Strain by mri and 3d speckle tracking echocardiography
International Journal of Cardiovascular Imaging, 2017Co-Authors: Alessandro Satriano, Bobak Heydari, Mariam Narous, Derek V Exner, Yoko Mikami, Monica M Attwood, John V Tyberg, Carmen P Lydell, Andrew G Howarth, Nowell M FineAbstract:Two-dimensional (2D) Strain analysis is conStrained by geometry-dependent reference directions of deformation (i.e. radial, circumferential, and longitudinal) following the assumption of cylindrical chamber architecture. Three-dimensional (3D) Principal Strain analysis may overcome such limitations by referencing intrinsic (i.e. Principal) directions of deformation. This study aimed to demonstrate clinical feasibility of 3D Principal Strain analysis from routine 2D cine MRI with validation to Strain from 2D tagged cine analysis and 3D speckle tracking echocardiography. Thirty-one patients undergoing cardiac MRI were studied. 3D Strain was measured from routine, multi-planar 2D cine SSFP images using custom software designed to apply 4D deformation fields to 3D cardiac models to derive Principal Strain. Comparisons of Strain estimates versus those by 2D tagged cine, 2D non-tagged cine (feature tracking), and 3D speckle tracking echocardiography (STE) were performed. Mean age was 51 ± 14 (36% female). Mean LV ejection fraction was 66 ± 10% (range 37–80%). 3D Principal Strain analysis was feasible in all subjects and showed high inter- and intra-observer reproducibility (ICC range 0.83–0.97 and 0.83–0.98, respectively—p < 0.001 for all directions). Strong correlations of minimum and maximum Principal Strain were respectively observed versus the following: 3D STE estimates of longitudinal (r = 0.81 and r = −0.64), circumferential (r = 0.76 and r = −0.58) and radial (r = −0.80 and r = 0.63) Strain (p < 0.001 for all); 2D tagged cine estimates of longitudinal (r = 0.81 and r = −0.81), circumferential (r = 0.87 and r = −0.85), and radial (r = −0.76 and r = 0.81) Strain (p < 0.0001 for all); and 2D cine (feature tracking) estimates of longitudinal (r = 0.85 and −0.83), circumferential (r = 0.88 and r = −0.87), and radial Strain (r = −0.79 and r = 0.84, p < 0.0001 for all). 3D Principal Strain analysis is feasible using routine, multi-planar 2D cine MRI and shows high reproducibility with strong correlations to 2D conventional Strain analysis and 3D STE-based analysis. Given its independence from geometry-related directions of deformation this technique may offer unique benefit for the detection and prognostication of myocardial disease, and warrants expanded investigation.
James A White - One of the best experts on this subject based on the ideXlab platform.
-
characterization of right ventricular deformation in pulmonary arterial hypertension using three dimensional Principal Strain analysis
Journal of The American Society of Echocardiography, 2019Co-Authors: Alessandro Satriano, Payam Pournazari, Naushad Hirani, Doug Helmersen, Mitesh V Thakrar, Jason Weatherald, James A White, Nowell M FineAbstract:Background Pulmonary arterial hypertension (PAH) can cause maladaptive right ventricular (RV) functional changes associated with adverse prognosis that are challenging to accurately quantify noninvasively. The aim of this study was to explore Principal Strain (PS) with contraction angle analysis using three-dimensional echocardiography to characterize RV deformation changes in patients with PAH. Methods Three-dimensional echocardiography was performed in 37 patients with PAH and 20 healthy control subjects with two-component (primary and secondary) PS and Principal contraction angle analysis. Patients were stratified according to World Health Organization (WHO) functional class. Results Primary PS differed significantly between patients with PAH and healthy control subjects (−20.2 ± 3.3% vs −26.8 ± 3.3%, P = .01), while secondary PS was not significantly different (3.6 ± 5.1% vs −2.5 ± 4.7%, P = .12). Principal contraction angle was significantly lower in patients with PAH (63 ± 22° vs 71 ± 7°, P = .01), with the greatest reduction for the RV free wall. Primary PS and Principal contraction angle differed significantly between WHO class I and II and class III and IV patients (−23.9 ± 4.7% vs −18.1 ± 4.8% [P = .03] and 69 ± 9° vs 58 ± 14° [P = .03], respectively), while secondary PS was not significantly different between groups (P = .13). Compared with healthy control subjects, septal Principal contraction angle was not different in patients with WHO class I and II PAH (P = .62), but it was significantly reduced in those with WHO class III and IV PAH (P Conclusions PS analysis using three-dimensional echocardiography provides comprehensive quantification of RV deformation and characterizes alterations occurring in PAH that are associated with WHO functional class.
-
Three-dimensional thoracic aorta Principal Strain analysis from routine ECG-gated computerized tomography: feasibility in patients undergoing transcatheter aortic valve replacement
BMC Cardiovascular Disorders, 2018Co-Authors: Alessandro Satriano, Carmen P Lydell, James A White, Zachary Guenther, Naeem Merchant, Elena S. Di Martino, Faisal Al-qoofi, Nowell M FineAbstract:Functional impairment of the aorta is a recognized complication of aortic and aortic valve disease. Aortic Strain measurement provides effective quantification of mechanical aortic function, and 3-dimenional (3D) approaches may be desirable for serial evaluation. Computerized tomographic angiography (CTA) is routinely performed for various clinical indications, and offers the unique potential to study 3D aortic deformation. We sought to investigate the feasibility of performing 3D aortic Strain analysis in a candidate population of patients undergoing transcatheter aortic valve replacement (TAVR). Twenty-one patients with severe aortic valve stenosis (AS) referred for TAVR underwent ECG-gated CTA and echocardiography. CTA images were analyzed using a 3D feature-tracking based technique to construct a dynamic aortic mesh model to perform peak Principal Strain amplitude (PPSA) analysis. Segmental Strain values were correlated against clinical, hemodynamic and echocardiographic variables. Reproducibility analysis was performed. The mean patient age was 81±6 years. Mean left ventricular ejection fraction was 52±14%, aortic valve area (AVA) 0.6±0.3 cm2 and mean AS pressure gradient (MG) 44±11 mmHg. CTA-based 3D PPSA analysis was feasible in all subjects. Mean PPSA values for the global thoracic aorta, ascending aorta, aortic arch and descending aorta segments were 6.5±3.0, 10.2±6.0, 6.1±2.9 and 3.3±1.7%, respectively. 3D PSSA values demonstrated significantly more impairment with measures of worsening AS severity, including AVA and MG for the global thoracic aorta and ascending segment (p
-
three dimensional thoracic aorta Principal Strain analysis from routine ecg gated computerized tomography feasibility in patients undergoing transcatheter aortic valve replacement
BMC Cardiovascular Disorders, 2018Co-Authors: Alessandro Satriano, Carmen P Lydell, James A White, Zachary Guenther, Naeem Merchant, Elena S. Di Martino, Faisal Alqoofi, Nowell M FineAbstract:Functional impairment of the aorta is a recognized complication of aortic and aortic valve disease. Aortic Strain measurement provides effective quantification of mechanical aortic function, and 3-dimenional (3D) approaches may be desirable for serial evaluation. Computerized tomographic angiography (CTA) is routinely performed for various clinical indications, and offers the unique potential to study 3D aortic deformation. We sought to investigate the feasibility of performing 3D aortic Strain analysis in a candidate population of patients undergoing transcatheter aortic valve replacement (TAVR). Twenty-one patients with severe aortic valve stenosis (AS) referred for TAVR underwent ECG-gated CTA and echocardiography. CTA images were analyzed using a 3D feature-tracking based technique to construct a dynamic aortic mesh model to perform peak Principal Strain amplitude (PPSA) analysis. Segmental Strain values were correlated against clinical, hemodynamic and echocardiographic variables. Reproducibility analysis was performed. The mean patient age was 81±6 years. Mean left ventricular ejection fraction was 52±14%, aortic valve area (AVA) 0.6±0.3 cm2 and mean AS pressure gradient (MG) 44±11 mmHg. CTA-based 3D PPSA analysis was feasible in all subjects. Mean PPSA values for the global thoracic aorta, ascending aorta, aortic arch and descending aorta segments were 6.5±3.0, 10.2±6.0, 6.1±2.9 and 3.3±1.7%, respectively. 3D PSSA values demonstrated significantly more impairment with measures of worsening AS severity, including AVA and MG for the global thoracic aorta and ascending segment (p<0.001 for all). 3D PSSA was independently associated with AVA by multivariable modelling. Coefficients of variation for intra- and inter-observer variability were 5.8 and 7.2%, respectively. Three-dimensional aortic PPSA analysis is clinically feasible from routine ECG-gated CTA. Appropriate reductions in PSSA were identified with increasing AS hemodynamic severity. Expanded study of 3D aortic PSSA for patients with various forms of aortic disease is warranted.
Carmen P Lydell - One of the best experts on this subject based on the ideXlab platform.
-
three dimensional thoracic aorta Principal Strain analysis from routine ecg gated computerized tomography feasibility in patients undergoing transcatheter aortic valve replacement
BMC Cardiovascular Disorders, 2018Co-Authors: Alessandro Satriano, Carmen P Lydell, James A White, Zachary Guenther, Naeem Merchant, Elena S. Di Martino, Faisal Alqoofi, Nowell M FineAbstract:Functional impairment of the aorta is a recognized complication of aortic and aortic valve disease. Aortic Strain measurement provides effective quantification of mechanical aortic function, and 3-dimenional (3D) approaches may be desirable for serial evaluation. Computerized tomographic angiography (CTA) is routinely performed for various clinical indications, and offers the unique potential to study 3D aortic deformation. We sought to investigate the feasibility of performing 3D aortic Strain analysis in a candidate population of patients undergoing transcatheter aortic valve replacement (TAVR). Twenty-one patients with severe aortic valve stenosis (AS) referred for TAVR underwent ECG-gated CTA and echocardiography. CTA images were analyzed using a 3D feature-tracking based technique to construct a dynamic aortic mesh model to perform peak Principal Strain amplitude (PPSA) analysis. Segmental Strain values were correlated against clinical, hemodynamic and echocardiographic variables. Reproducibility analysis was performed. The mean patient age was 81±6 years. Mean left ventricular ejection fraction was 52±14%, aortic valve area (AVA) 0.6±0.3 cm2 and mean AS pressure gradient (MG) 44±11 mmHg. CTA-based 3D PPSA analysis was feasible in all subjects. Mean PPSA values for the global thoracic aorta, ascending aorta, aortic arch and descending aorta segments were 6.5±3.0, 10.2±6.0, 6.1±2.9 and 3.3±1.7%, respectively. 3D PSSA values demonstrated significantly more impairment with measures of worsening AS severity, including AVA and MG for the global thoracic aorta and ascending segment (p<0.001 for all). 3D PSSA was independently associated with AVA by multivariable modelling. Coefficients of variation for intra- and inter-observer variability were 5.8 and 7.2%, respectively. Three-dimensional aortic PPSA analysis is clinically feasible from routine ECG-gated CTA. Appropriate reductions in PSSA were identified with increasing AS hemodynamic severity. Expanded study of 3D aortic PSSA for patients with various forms of aortic disease is warranted.
-
Three-dimensional thoracic aorta Principal Strain analysis from routine ECG-gated computerized tomography: feasibility in patients undergoing transcatheter aortic valve replacement
BMC Cardiovascular Disorders, 2018Co-Authors: Alessandro Satriano, Carmen P Lydell, James A White, Zachary Guenther, Naeem Merchant, Elena S. Di Martino, Faisal Al-qoofi, Nowell M FineAbstract:Functional impairment of the aorta is a recognized complication of aortic and aortic valve disease. Aortic Strain measurement provides effective quantification of mechanical aortic function, and 3-dimenional (3D) approaches may be desirable for serial evaluation. Computerized tomographic angiography (CTA) is routinely performed for various clinical indications, and offers the unique potential to study 3D aortic deformation. We sought to investigate the feasibility of performing 3D aortic Strain analysis in a candidate population of patients undergoing transcatheter aortic valve replacement (TAVR). Twenty-one patients with severe aortic valve stenosis (AS) referred for TAVR underwent ECG-gated CTA and echocardiography. CTA images were analyzed using a 3D feature-tracking based technique to construct a dynamic aortic mesh model to perform peak Principal Strain amplitude (PPSA) analysis. Segmental Strain values were correlated against clinical, hemodynamic and echocardiographic variables. Reproducibility analysis was performed. The mean patient age was 81±6 years. Mean left ventricular ejection fraction was 52±14%, aortic valve area (AVA) 0.6±0.3 cm2 and mean AS pressure gradient (MG) 44±11 mmHg. CTA-based 3D PPSA analysis was feasible in all subjects. Mean PPSA values for the global thoracic aorta, ascending aorta, aortic arch and descending aorta segments were 6.5±3.0, 10.2±6.0, 6.1±2.9 and 3.3±1.7%, respectively. 3D PSSA values demonstrated significantly more impairment with measures of worsening AS severity, including AVA and MG for the global thoracic aorta and ascending segment (p
-
clinical feasibility and validation of 3d Principal Strain analysis from cine mri comparison to 2d Strain by mri and 3d speckle tracking echocardiography
International Journal of Cardiovascular Imaging, 2017Co-Authors: Alessandro Satriano, Bobak Heydari, Mariam Narous, Derek V Exner, Yoko Mikami, Monica M Attwood, John V Tyberg, Carmen P Lydell, Andrew G Howarth, Nowell M FineAbstract:Two-dimensional (2D) Strain analysis is conStrained by geometry-dependent reference directions of deformation (i.e. radial, circumferential, and longitudinal) following the assumption of cylindrical chamber architecture. Three-dimensional (3D) Principal Strain analysis may overcome such limitations by referencing intrinsic (i.e. Principal) directions of deformation. This study aimed to demonstrate clinical feasibility of 3D Principal Strain analysis from routine 2D cine MRI with validation to Strain from 2D tagged cine analysis and 3D speckle tracking echocardiography. Thirty-one patients undergoing cardiac MRI were studied. 3D Strain was measured from routine, multi-planar 2D cine SSFP images using custom software designed to apply 4D deformation fields to 3D cardiac models to derive Principal Strain. Comparisons of Strain estimates versus those by 2D tagged cine, 2D non-tagged cine (feature tracking), and 3D speckle tracking echocardiography (STE) were performed. Mean age was 51 ± 14 (36% female). Mean LV ejection fraction was 66 ± 10% (range 37–80%). 3D Principal Strain analysis was feasible in all subjects and showed high inter- and intra-observer reproducibility (ICC range 0.83–0.97 and 0.83–0.98, respectively—p < 0.001 for all directions). Strong correlations of minimum and maximum Principal Strain were respectively observed versus the following: 3D STE estimates of longitudinal (r = 0.81 and r = −0.64), circumferential (r = 0.76 and r = −0.58) and radial (r = −0.80 and r = 0.63) Strain (p < 0.001 for all); 2D tagged cine estimates of longitudinal (r = 0.81 and r = −0.81), circumferential (r = 0.87 and r = −0.85), and radial (r = −0.76 and r = 0.81) Strain (p < 0.0001 for all); and 2D cine (feature tracking) estimates of longitudinal (r = 0.85 and −0.83), circumferential (r = 0.88 and r = −0.87), and radial Strain (r = −0.79 and r = 0.84, p < 0.0001 for all). 3D Principal Strain analysis is feasible using routine, multi-planar 2D cine MRI and shows high reproducibility with strong correlations to 2D conventional Strain analysis and 3D STE-based analysis. Given its independence from geometry-related directions of deformation this technique may offer unique benefit for the detection and prognostication of myocardial disease, and warrants expanded investigation.
Elena S. Di Martino - One of the best experts on this subject based on the ideXlab platform.
-
Three-dimensional thoracic aorta Principal Strain analysis from routine ECG-gated computerized tomography: feasibility in patients undergoing transcatheter aortic valve replacement
BMC Cardiovascular Disorders, 2018Co-Authors: Alessandro Satriano, Carmen P Lydell, James A White, Zachary Guenther, Naeem Merchant, Elena S. Di Martino, Faisal Al-qoofi, Nowell M FineAbstract:Functional impairment of the aorta is a recognized complication of aortic and aortic valve disease. Aortic Strain measurement provides effective quantification of mechanical aortic function, and 3-dimenional (3D) approaches may be desirable for serial evaluation. Computerized tomographic angiography (CTA) is routinely performed for various clinical indications, and offers the unique potential to study 3D aortic deformation. We sought to investigate the feasibility of performing 3D aortic Strain analysis in a candidate population of patients undergoing transcatheter aortic valve replacement (TAVR). Twenty-one patients with severe aortic valve stenosis (AS) referred for TAVR underwent ECG-gated CTA and echocardiography. CTA images were analyzed using a 3D feature-tracking based technique to construct a dynamic aortic mesh model to perform peak Principal Strain amplitude (PPSA) analysis. Segmental Strain values were correlated against clinical, hemodynamic and echocardiographic variables. Reproducibility analysis was performed. The mean patient age was 81±6 years. Mean left ventricular ejection fraction was 52±14%, aortic valve area (AVA) 0.6±0.3 cm2 and mean AS pressure gradient (MG) 44±11 mmHg. CTA-based 3D PPSA analysis was feasible in all subjects. Mean PPSA values for the global thoracic aorta, ascending aorta, aortic arch and descending aorta segments were 6.5±3.0, 10.2±6.0, 6.1±2.9 and 3.3±1.7%, respectively. 3D PSSA values demonstrated significantly more impairment with measures of worsening AS severity, including AVA and MG for the global thoracic aorta and ascending segment (p
-
three dimensional thoracic aorta Principal Strain analysis from routine ecg gated computerized tomography feasibility in patients undergoing transcatheter aortic valve replacement
BMC Cardiovascular Disorders, 2018Co-Authors: Alessandro Satriano, Carmen P Lydell, James A White, Zachary Guenther, Naeem Merchant, Elena S. Di Martino, Faisal Alqoofi, Nowell M FineAbstract:Functional impairment of the aorta is a recognized complication of aortic and aortic valve disease. Aortic Strain measurement provides effective quantification of mechanical aortic function, and 3-dimenional (3D) approaches may be desirable for serial evaluation. Computerized tomographic angiography (CTA) is routinely performed for various clinical indications, and offers the unique potential to study 3D aortic deformation. We sought to investigate the feasibility of performing 3D aortic Strain analysis in a candidate population of patients undergoing transcatheter aortic valve replacement (TAVR). Twenty-one patients with severe aortic valve stenosis (AS) referred for TAVR underwent ECG-gated CTA and echocardiography. CTA images were analyzed using a 3D feature-tracking based technique to construct a dynamic aortic mesh model to perform peak Principal Strain amplitude (PPSA) analysis. Segmental Strain values were correlated against clinical, hemodynamic and echocardiographic variables. Reproducibility analysis was performed. The mean patient age was 81±6 years. Mean left ventricular ejection fraction was 52±14%, aortic valve area (AVA) 0.6±0.3 cm2 and mean AS pressure gradient (MG) 44±11 mmHg. CTA-based 3D PPSA analysis was feasible in all subjects. Mean PPSA values for the global thoracic aorta, ascending aorta, aortic arch and descending aorta segments were 6.5±3.0, 10.2±6.0, 6.1±2.9 and 3.3±1.7%, respectively. 3D PSSA values demonstrated significantly more impairment with measures of worsening AS severity, including AVA and MG for the global thoracic aorta and ascending segment (p<0.001 for all). 3D PSSA was independently associated with AVA by multivariable modelling. Coefficients of variation for intra- and inter-observer variability were 5.8 and 7.2%, respectively. Three-dimensional aortic PPSA analysis is clinically feasible from routine ECG-gated CTA. Appropriate reductions in PSSA were identified with increasing AS hemodynamic severity. Expanded study of 3D aortic PSSA for patients with various forms of aortic disease is warranted.
