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Rossini L, Martinez-Legazpi P, Benito Y, Del Villar CP, Gonzalez-Mansilla A, Barrio A, Borja MG, Yotti R, Kahn AM, Shadden SC, Fernández-Avilés F, Bermejo J, Del Álamo JC. Clinical assessment of intraventricular blood transport in patients undergoing cardiac resynchronization therapy. MECCANICA 2017; 52:563-576. [PMID: 31080296 PMCID: PMC6508690 DOI: 10.1007/s11012-015-0322-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 11/05/2015] [Indexed: 06/03/2023]
Abstract
In the healthy heart, left ventricular (LV) filling generates different flow patterns which have been proposed to optimize blood transport by coupling diastole and systole. This work presents a novel image-based method to assess how different flow patterns influence LV blood transport in patients undergoing cardiac resynchronization therapy (CRT). Our approach is based on solving the advection equation for a passive scalar field from time-resolved blood velocity fields. Imposing time-varying inflow boundary conditions for the scalar field provides a straightforward method to distinctly track the transport of blood entering the LV in the different filling waves of a given cardiac cycle, as well as the transport barriers which couple filling and ejection. We applied this method to analyze flow transport in a group of patients with implanted CRT devices and a group of healthy volunteers. Velocity fields were obtained using echocardiographic color Doppler velocimetry, which provides two-dimensional time-resolved flow maps in the apical long axis three-chamber view of the LV. In the patients under CRT, the device programming was varied to analyze flow transport under different values of the atrioventricular conduction delay, and to model tachycardia (100 bpm). Using this method, we show how CRT influences the transit of blood inside the left ventricle, contributes to conserving kinetic energy, and favors the generation of hemodynamic forces that accelerate blood in the direction of the LV outflow tract. These novel aspects of ventricular function are clinically accessible by quantitative analysis of color-Doppler echocardiograms.
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Affiliation(s)
- Lorenzo Rossini
- Mechanical and Aerospace Engineering Department, University of California San Diego, Mail Code 0411 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Pablo Martinez-Legazpi
- Mechanical and Aerospace Engineering Department, University of California San Diego, Mail Code 0411 9500 Gilman Drive, La Jolla, CA 92093, USA; Department of Cardiology, Instituto de Investigación Sanitaria Gregorio Marañó n, Hospital General Universitario Gregorio Marañón , Dr. Esquerdo 46, 28007 Madrid, Spain
| | - Yolanda Benito
- Department of Cardiology, Instituto de Investigación Sanitaria Gregorio Marañó n, Hospital General Universitario Gregorio Marañón , Dr. Esquerdo 46, 28007 Madrid, Spain
| | - Candelas Pérez Del Villar
- Department of Cardiology, Instituto de Investigación Sanitaria Gregorio Marañó n, Hospital General Universitario Gregorio Marañón , Dr. Esquerdo 46, 28007 Madrid, Spain
| | - Ana Gonzalez-Mansilla
- Department of Cardiology, Instituto de Investigación Sanitaria Gregorio Marañó n, Hospital General Universitario Gregorio Marañón , Dr. Esquerdo 46, 28007 Madrid, Spain
| | - Alicia Barrio
- Department of Cardiology, Instituto de Investigación Sanitaria Gregorio Marañó n, Hospital General Universitario Gregorio Marañón , Dr. Esquerdo 46, 28007 Madrid, Spain
| | - María-Guadalupe Borja
- Mechanical and Aerospace Engineering Department, University of California San Diego, Mail Code 0411 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Raquel Yotti
- Department of Cardiology, Instituto de Investigación Sanitaria Gregorio Marañó n, Hospital General Universitario Gregorio Marañón , Dr. Esquerdo 46, 28007 Madrid, Spain
| | - Andrew M Kahn
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Shawn C Shadden
- Mechanical Engineering Department, University of California Berkeley, Berkeley, CA, USA
| | - Francisco Fernández-Avilés
- Department of Cardiology, Instituto de Investigación Sanitaria Gregorio Marañó n, Hospital General Universitario Gregorio Marañón , Dr. Esquerdo 46, 28007 Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Javier Bermejo
- Department of Cardiology, Instituto de Investigación Sanitaria Gregorio Marañó n, Hospital General Universitario Gregorio Marañón , Dr. Esquerdo 46, 28007 Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan C Del Álamo
- Mechanical and Aerospace Engineering Department, University of California San Diego, Mail Code 0411 9500 Gilman Drive, La Jolla, CA 92093, USA, Institute for Engineering in Medicine, University of California San Diego, La Jolla, CA, USA
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Steelant B, Stankovic I, Roijakkers I, Aarones M, Bogaert J, Desmet W, Aakhus S, Voigt JU. The Impact of Infarct Location and Extent on LV Motion Patterns. JACC Cardiovasc Imaging 2016; 9:655-64. [DOI: 10.1016/j.jcmg.2015.07.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 06/25/2015] [Accepted: 07/15/2015] [Indexed: 12/14/2022]
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Dominguez-Rodriguez A, Abreu-Gonzalez P. Criterios de uso apropiado para la ergoespirometría en el paciente portador de dispositivos de resincronización cardiaca. Rev Esp Cardiol (Engl Ed) 2014. [DOI: 10.1016/j.recesp.2013.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dominguez-Rodriguez A, Abreu-Gonzalez P. Appropriate use criteria for cardiopulmonary exercise testing in patients with cardiac resynchronization devices. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2014; 67:156. [PMID: 24795132 DOI: 10.1016/j.rec.2013.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 09/17/2013] [Indexed: 06/03/2023]
Affiliation(s)
- Alberto Dominguez-Rodriguez
- Servicio de Cardiología, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Universidad Europea de Canarias, Facultad de Ciencias de la Salud, Santa Cruz de Tenerife, Spain; Instituto Universitario de Tecnologías Biomédicas, Santa Cruz de Tenerife, Spain.
| | - Pedro Abreu-Gonzalez
- Instituto Universitario de Tecnologías Biomédicas, Santa Cruz de Tenerife, Spain; Universidad de La Laguna, Departamento de Fisiología, Santa Cruz de Tenerife, Spain
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Applicability of the iterative technique for cardiac resynchronization therapy optimization: full-disclosure, 50-sequential-patient dataset of transmitral Doppler traces, with implications for future research design and guidelines. ACTA ACUST UNITED AC 2013; 16:541-50. [DOI: 10.1093/europace/eut257] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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6
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Normality index of ventricular contraction based on a statistical model from FADS. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2013; 2013:617604. [PMID: 23634177 PMCID: PMC3619624 DOI: 10.1155/2013/617604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 02/22/2013] [Indexed: 11/17/2022]
Abstract
Radionuclide-based imaging is an alternative to evaluate ventricular function and synchrony and may be used as a tool for the identification of patients that could benefit from cardiac resynchronization therapy (CRT). In a previous work, we used Factor Analysis of Dynamic Structures (FADS) to analyze the contribution and spatial distribution of the 3 most significant factors (3-MSF) present in a dynamic series of equilibrium radionuclide angiography images. In this work, a probability density function model of the 3-MSF extracted from FADS for a control group is presented; also an index, based on the likelihood between the control group's contraction model and a sample of normal subjects is proposed. This normality index was compared with those computed for two cardiopathic populations, satisfying the clinical criteria to be considered as candidates for a CRT. The proposed normality index provides a measure, consistent with the phase analysis currently used in clinical environment, sensitive enough to show contraction differences between normal and abnormal groups, which suggests that it can be related to the degree of severity in the ventricular contraction dyssynchrony, and therefore shows promise as a follow-up procedure for patients under CRT.
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Wang D, Yu H, Yun T, Zang H, Yang G, Wang S, Wang Z, Jing Q, Han Y. Long-term clinical effects of programmer-guided atrioventricular and interventricular delay optimization: Intracardiac electrography versus echocardiography for cardiac resynchronization therapy in patients with heart failure. J Int Med Res 2013; 41:115-22. [PMID: 23569136 DOI: 10.1177/0300060512474570] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives To compare the haemodynamic results and long-term clinical outcomes of intracardiac electrography (QuickOpt®; St Jude Medical, St Paul, MN, USA) and echocardiography for optimization of atrioventricular (AV) and interventricular (VV) delays in cardiac resynchronization therapy (CRT). Methods Patients with CRT devices were prospectively enrolled; AV/VV delays were optimized by either QuickOpt® or echocardiography. Patients in the QuickOpt® group underwent both echocardiography and QuickOpt® optimization, and QuickOpt® AV/VV delays were used to program the CRT. All patients were followed-up for 12 months. Results In total, 44 patients were enrolled. There was good correlation between AV/VV delays determined by QuickOpt® ( n = 20) and echocardiography ( n = 24). QuickOpt® was significantly faster than echocardiography-guided optimization. Cardiac function, 6-min walking distance and left ventricular ejection fraction were significantly and similarly improved in both groups at 6 and 12 months compared with baseline. In the QuickOpt® group, left ventricular end diastolic diameters were significantly smaller at 6 and 12 months compared with baseline. Conclusions QuickOpt® is a quick, convenient and easy to perform method for optimization of AV and VV delays, with a similar long-term clinical outcome to echocardiography-guided optimization.
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Affiliation(s)
- Dongmei Wang
- Department of Cardiology, Bethune International Peace Hospital, Shijiazhuang, China
- Department of Cardiology, Shenyang Northern Hospital, Shenyang, China
| | - Haibo Yu
- Department of Cardiology, Shenyang Northern Hospital, Shenyang, China
| | - Tian Yun
- Department of Cardiology, Shenyang Northern Hospital, Shenyang, China
| | - Hongyun Zang
- Department of Cardiology, Shenyang Northern Hospital, Shenyang, China
| | - Guitang Yang
- Department of Cardiology, Shenyang Northern Hospital, Shenyang, China
| | - Shouli Wang
- Department of Cardiology, Shenyang Northern Hospital, Shenyang, China
- Department of Cardiology, the 306 Hospital of PLA, Beijing, China
| | - Zulu Wang
- Department of Cardiology, Shenyang Northern Hospital, Shenyang, China
| | - Quanmin Jing
- Department of Cardiology, Shenyang Northern Hospital, Shenyang, China
| | - Yaling Han
- Department of Cardiology, Shenyang Northern Hospital, Shenyang, China
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Kutyifa V, Breithardt OA. Evaluación del paciente que no responde al tratamiento de resincronización cardiaca: un enfoque escalonado completo. Rev Esp Cardiol 2012; 65:504-10. [DOI: 10.1016/j.recesp.2011.12.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 12/23/2011] [Indexed: 11/28/2022]
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Straka F, Pirk J, Pindak M, Marek T, Schornik D, Cihak R, Skibova J. A Pilot Study of Systolic Dyssynchrony Index by Real Time Three-Dimensional Echocardiography and Doppler Tissue Imaging Parameters Predicting the Hemodynamic Response to Biventricular Pacing in the Early Postoperative Period after Cardiac Surgery. Echocardiography 2012; 29:827-39. [DOI: 10.1111/j.1540-8175.2012.01694.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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STRAKA FRANTISEK, PIRK JAN, PINDAK MARIAN, SKALSKY IVO, VANCURA VLASTIMIL, CIHAK ROBERT, MAREK TOMAS, LUPINEK PETR, MASIN JAROSLAV, SCHORNIK DAVID, ZEMAN MICHAL, SKROBAKOVA JANKA, DORAZILOVA ZORA, SKIBOVA JELENA. The Hemodynamic Effect of Right Ventricle (RV), RT3DE Targeted Left Ventricle (LV) and Biventricular (BIV) Pacing in the Early Postoperative Period After Cardiac Surgery. Pacing Clin Electrophysiol 2011; 34:1231-40. [DOI: 10.1111/j.1540-8159.2011.03161.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Costa RA, Reiber JHC, Rybicki FJ, Schoenhagen P, Stillman AA, de Sutter J, van de Veire NRL, van der Wall EE. Cardiovascular imaging 2010 in the International Journal of Cardiovascular Imaging. Int J Cardiovasc Imaging 2011; 27:309-19. [PMID: 21347592 PMCID: PMC3092067 DOI: 10.1007/s10554-011-9834-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 02/08/2011] [Indexed: 01/20/2023]
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Geng J, Wu B, Zheng L, Zhu J. Heart failure patients selection for cardiac resynchronization therapy. Eur J Intern Med 2011; 22:32-8. [PMID: 21238890 DOI: 10.1016/j.ejim.2010.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2010] [Revised: 10/27/2010] [Accepted: 11/02/2010] [Indexed: 11/19/2022]
Abstract
Cardiac resynchronization therapy (CRT) is an established treatment for refractory chronic heart failure (CHF) patients with ventricular dyssynchrony. The patient selection for this therapy remains the basis for response improvement. Various parameters, methods and technology for identification of appropriate patient are under research. The influences of age and gender, disease progress stage such as mild and late stage CHF including right ventricular dysfunction, dyssynchrony and scar identified by imaging techniques like echocardiography, magnetic resonance and nuclear imaging, and atrial fibrillation on CRT benefits were respectively discussed. This review summarizes the current advancement in these areas.
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Affiliation(s)
- Junchao Geng
- Department of Cardiology, No 1 Hospital affiliated to Medical School of Zhejiang University, Hangzhou, China
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Evidence of scar tissue: contra-indication to cardiac resynchronization therapy? Int J Cardiovasc Imaging 2010; 27:59-63. [PMID: 20614190 PMCID: PMC3035785 DOI: 10.1007/s10554-010-9664-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Accepted: 06/25/2010] [Indexed: 11/06/2022]
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14
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Cardiac resynchronization therapy; the importance of evaluating cardiac metabolism. Int J Cardiovasc Imaging 2010; 26:293-7. [PMID: 20148366 PMCID: PMC2846327 DOI: 10.1007/s10554-010-9597-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Accepted: 01/26/2010] [Indexed: 10/25/2022]
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15
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Baur LHB. Echocardiography as a guidance in CRT management: the GPS system in a labyrinth? Int J Cardiovasc Imaging 2010; 26:193-5. [PMID: 20033489 PMCID: PMC2817078 DOI: 10.1007/s10554-009-9555-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Accepted: 12/01/2009] [Indexed: 11/26/2022]
Abstract
Although progress has been made to understand the factors for non-responsiveness, fine tuning and comprehensive strategies are needed to make echocardiography the GPS system in cardiac resynchronization. Taking the wrong turn in the labyrinth of dyssynchrony is expensive and time consuming without improving well being of the heart failure patient. Possibly other imaging techniques could help in fine tuning cardiac resynchronization.
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Affiliation(s)
- Leo H. B. Baur
- Department of Cardiology, Atrium Medical Centre Parkstad, University of Maastricht, Henri Dunantstreet 5, 6401 CX Heerlen, The Netherlands
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16
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van der Wall EE, Schalij MJ, Bax JJ. Cardiac resynchronization therapy; evaluation by advanced imaging techniques. Int J Cardiovasc Imaging 2009; 26:199-202. [PMID: 20039137 PMCID: PMC2817077 DOI: 10.1007/s10554-009-9560-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Accepted: 12/14/2009] [Indexed: 11/30/2022]
Affiliation(s)
- E. E. van der Wall
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, The Netherlands
| | - M. J. Schalij
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, The Netherlands
| | - J. J. Bax
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, The Netherlands
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