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Farrar G, Suinesiaputra A, Gilbert K, Perry JC, Hegde S, Marsden A, Young AA, Omens JH, McCulloch AD. Atlas-Based Ventricular Shape Analysis for Understanding Congenital Heart Disease. PROGRESS IN PEDIATRIC CARDIOLOGY 2016; 43:61-69. [PMID: 28082823 DOI: 10.1016/j.ppedcard.2016.07.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Congenital heart disease is associated with abnormal ventricular shape that can affect wall mechanics and may be predictive of long-term adverse outcomes. Atlas-based parametric shape analysis was used to analyze ventricular geometries of eight adolescent or adult single-ventricle CHD patients with tricuspid atresia and Fontans. These patients were compared with an "atlas" of non-congenital asymptomatic volunteers, resulting in a set of z-scores which quantify deviations from the control population distribution on a patient-by-patient basis. We examined the potential of these scores to: (1) quantify abnormalities of ventricular geometry in single ventricle physiologies relative to the normal population; (2) comprehensively quantify wall motion in CHD patients; and (3) identify possible relationships between ventricular shape and wall motion that may reflect underlying functional defects or remodeling in CHD patients. CHD ventricular geometries at end-diastole and end-systole were individually compared with statistical shape properties of an asymptomatic population from the Cardiac Atlas Project. Shape analysis-derived model properties, and myocardial wall motions between end-diastole and end-systole, were compared with physician observations of clinical functional parameters. Relationships between altered shape and altered function were evaluated via correlations between atlas-based shape and wall motion scores. Atlas-based shape analysis identified a diverse set of specific quantifiable abnormalities in ventricular geometry or myocardial wall motion in all subjects. Moreover, this initial cohort displayed significant relationships between specific shape abnormalities such as increased ventricular sphericity and functional defects in myocardial deformation, such as decreased long-axis wall motion. These findings suggest that atlas-based ventricular shape analysis may be a useful new tool in the management of patients with CHD who are at risk of impaired ventricular wall mechanics and chamber remodeling.
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Affiliation(s)
- Genevieve Farrar
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA
| | - Avan Suinesiaputra
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, NZ
| | - Kathleen Gilbert
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, NZ
| | - James C Perry
- Division of Cardiology, Rady Children's Hospital, San Diego, CA, USA; Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Sanjeet Hegde
- Division of Cardiology, Rady Children's Hospital, San Diego, CA, USA; Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Alison Marsden
- Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - Alistair A Young
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, NZ
| | - Jeffrey H Omens
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA; Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Andrew D McCulloch
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA; Department of Medicine, University of California San Diego, La Jolla, CA, USA
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Young AA, Prince JL. Cardiovascular magnetic resonance: deeper insights through bioengineering. Annu Rev Biomed Eng 2013; 15:433-61. [PMID: 23662778 DOI: 10.1146/annurev-bioeng-071812-152346] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Heart disease is the main cause of morbidity and mortality worldwide, with coronary artery disease, diabetes, and obesity being major contributing factors. Cardiovascular magnetic resonance (CMR) can provide a wealth of quantitative information on the performance of the heart, without risk to the patient. Quantitative analyses of these data can substantially augment the diagnostic quality of CMR examinations and can lead to more effective characterization of disease and quantification of treatment benefit. This review provides an overview of the current state of the art in CMR with particular regard to the quantification of motion, both microscopic and macroscopic, and the application of bioengineering analysis for the evaluation of cardiac mechanics. We discuss the current clinical practice and the likely advances in the next 5-10 years, as well as the ways in which clinical examinations can be augmented by bioengineering analysis of strain, compliance, and stress.
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Affiliation(s)
- A A Young
- Department of Anatomy with Radiology, School of Medical Science, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand.
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