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Johnson MD, Zimmerman KG, Nakashima T, Urrea KA, Rojas-Pena A, Bartlett RH, Drake DH. Artificial Intelligence-Assisted Strain Echocardiography in an Ex Vivo Heart. ASAIO J 2023; 69:e523-e525. [PMID: 37524082 DOI: 10.1097/mat.0000000000001994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Affiliation(s)
- Matthew D Johnson
- From the Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Karen G Zimmerman
- Department of Cardiology, Henry Ford Health System, Detroit, Michigan
| | - Takahiro Nakashima
- From the Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Kristopher A Urrea
- From the Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Alvaro Rojas-Pena
- From the Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Robert H Bartlett
- From the Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Daniel H Drake
- Department of Cardiac Surgery, University of Michigan Medical School, Ann Arbor, Michigan
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Pastrama M, van Hees R, Stavenuiter I, Petterson NJ, Ito K, Lopata R, van Donkelaar CC. Characterization of intra-tissue strain fields in articular cartilage explants during post-loading recovery using high frequency ultrasound. J Biomech 2022; 145:111370. [PMID: 36375264 DOI: 10.1016/j.jbiomech.2022.111370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/02/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
Abstract
This study aims to demonstrate the potential of ultrasound elastography as a research tool for non-destructive imaging of intra-tissue strain fields and tissue quality assessment in cartilage explants. Osteochondral plugs from bovine patellae were loaded up to 10, 40, or 70 N using a hemi-spherical indenter. The load was kept constant for 15 min, after which samples were unloaded and ultrasound imaging of strain recovery over time was performed in the indented area for 1 h. Tissue strains were determined using speckle tracking and accumulated to LaGrangian strains in the indentation direction. For all samples, strain maps showed a heterogeneous strain field, with the highest values in the superficial cartilage under the indenter tip at the bottom of the indent and decreasing values in the deeper cartilage. Strains were higher at higher load levels and tissue recovery over time was faster after indentation at 10 N than at 40 N and 70 N. At lower compression levels most displacement occurred near the surface with little deformation in the deep layers, while at higher levels strains increased more evenly in all cartilage zones. Ultrasound elastography is a promising method for high resolution imaging of intra-tissue strain fields and evaluation of cartilage quality in tissue explants in a laboratory setting. In the future, it may become a clinical diagnostic tool used to identify the extent of cartilage damage around visible defects.
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Affiliation(s)
- Maria Pastrama
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Roy van Hees
- Cardiovascular Biomechanics, Photoacoustics & Ultrasound Laboratory Eindhoven (PULS/e), Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Isabel Stavenuiter
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Niels J Petterson
- Cardiovascular Biomechanics, Photoacoustics & Ultrasound Laboratory Eindhoven (PULS/e), Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Keita Ito
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Richard Lopata
- Cardiovascular Biomechanics, Photoacoustics & Ultrasound Laboratory Eindhoven (PULS/e), Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Corrinus C van Donkelaar
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands.
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Fixsen LS, Petterson NJ, Houthuizen P, Rutten MCM, van de Vosse FN, Lopata RGP. Ultrasound-based estimation of remaining cardiac function in LVAD-supported ex vivo hearts. Artif Organs 2020; 44:E326-E336. [PMID: 32242944 PMCID: PMC7496524 DOI: 10.1111/aor.13693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 02/05/2020] [Accepted: 03/23/2020] [Indexed: 11/28/2022]
Abstract
Left ventricular assist devices (LVAD) provide cardiac support to patients with advanced heart failure. Methods that can directly measure remaining LV function following device implantation do not currently exist. Previous studies have shown that a combination of loading (LV pressure) and deformation (strain) measurements enables quantitation of myocardial work. We investigated the use of ultrasound (US) strain imaging and pressure–strain loop analysis in LVAD‐supported hearts under different hemodynamic and pump unloading conditions, with the aim of determining LV function with and without LVAD support. Ex vivo porcine hearts (n = 4) were implanted with LVADs and attached to a mock circulatory loop. Measurements were performed at hemodynamically defined “heart conditions” as the hearts deteriorated from baseline. Hemodynamic (including LV pressure) and radio‐frequency US data were acquired during a pump‐ramp protocol at speeds from 0 (with no pump outflow) to 10 000 revolutions per minute (rpm). Regional circumferential (εcirc) and radial (εrad) strains were estimated over each heart cycle. Regional ventricular dyssynchrony was quantitated through time‐to‐peak strain. Mean change in LV pulse pressure and εcirc between 0 and 10 krpm were −21.8 mm Hg and −7.24% in the first condition; in the final condition −46.8 mm Hg and −19.2%, respectively. εrad was not indicative of changes in pump speed or heart condition. Pressure–strain loops showed a degradation in the LV function and an increased influence of LV unloading: loop area reduced by 90% between 0 krpm in the first heart condition and 10 krpm in the last condition. High pump speeds and degraded condition led to increased dyssynchrony between the septal and lateral LV walls. Functional measurement of the LV while undergoing LVAD support is possible by using US strain imaging and pressure–strain loops. This can provide important information about remaining pump function. Use of novel LV pressure estimation or measurement techniques would be required for any future use in LVAD patients.
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Affiliation(s)
- Louis S Fixsen
- Cardiovascular Biomechanics group, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Niels J Petterson
- Cardiovascular Biomechanics group, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Patrick Houthuizen
- Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands
| | - Marcel C M Rutten
- Cardiovascular Biomechanics group, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Frans N van de Vosse
- Cardiovascular Biomechanics group, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Richard G P Lopata
- Cardiovascular Biomechanics group, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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Ferraiuoli P, Fixsen LS, Kappler B, Lopata RGP, Fenner JW, Narracott AJ. Measurement of in vitro cardiac deformation by means of 3D digital image correlation and ultrasound 2D speckle-tracking echocardiography. Med Eng Phys 2019; 74:146-152. [PMID: 31615731 DOI: 10.1016/j.medengphy.2019.09.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 07/26/2019] [Accepted: 09/29/2019] [Indexed: 11/16/2022]
Abstract
Ultrasound-based 2D speckle-tracking echocardiography (US-2D-STE) is increasingly used to assess the functionality of the heart. In particular, the analysis of cardiac strain plays an important role in the identification of several cardiovascular diseases. However, this imaging technique presents some limitations associated with its operating principle that result in low accuracy and reproducibility of the measurement. In this study, an experimental framework for multimodal strain imaging in an in vitro porcine heart was developed. Specifically, the aim of this work was to analyse displacement and strain in the heart by means of 3D digital image correlation (3D-DIC) and US-2D-STE. Over a single cardiac cycle, displacement values obtained from the two techniques were in strong correlation, although systematically larger displacements were observed with 3D-DIC. Notwithstanding an absolute comparison of the strain measurements was not possible to achieve between the two methods, maximum principal strain directions computed with 3D-DIC were consistent with the longitudinal and circumferential strain distribution measured with US-2D-STE. 3D-DIC confirmed its high repeatability in quantifying displacement and strain over multiple cardiac cycles, unlike US-2D-STE which is affected by accumulated errors over time (i.e. drift). To conclude, this study demonstrates the potential of 3D-DIC to perform dynamic measurement of displacement and strain during heart deformations and supports future applications of this method in ex vivo beating heart platforms, which replicate more fully the complex contraction of the heart.
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Affiliation(s)
- Paolo Ferraiuoli
- Mathematical Modelling in Medicine Group, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom; Insigneo Institute for in silico medicine, University of Sheffield, Sheffield, United Kingdom.
| | - Louis S Fixsen
- Cardiovascular Biomechanics group, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Benjamin Kappler
- LifeTec Group B.V., Eindhoven, Netherlands; Amsterdam University Medical Center, Department Cardiothoracic Surgery, Amsterdam, Netherlands
| | - Richard G P Lopata
- Cardiovascular Biomechanics group, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - John W Fenner
- Mathematical Modelling in Medicine Group, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom; Insigneo Institute for in silico medicine, University of Sheffield, Sheffield, United Kingdom
| | - Andrew J Narracott
- Mathematical Modelling in Medicine Group, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom; Insigneo Institute for in silico medicine, University of Sheffield, Sheffield, United Kingdom.
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Ferraiuoli P, Kappler B, van Tuijl S, Stijnen M, de Mol BA, Fenner JW, Narracott AJ. Full-field analysis of epicardial strain in an in vitro porcine heart platform. J Mech Behav Biomed Mater 2019; 91:294-300. [DOI: 10.1016/j.jmbbm.2018.11.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/24/2018] [Accepted: 11/26/2018] [Indexed: 01/29/2023]
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