Name: Évaluation de la structure et de la fonction ventriculaires gauches à l’aide de l’échocardiographie 3D (Vidéo) | JoVE Journal
Uploaded: 2020-10-28T12:30:00.000+00:00
Duration: 6 min 34 s
Description: Apprenez l'évaluation volumétrique et le speckle-tracking du ventricule gauche par échocardiographie 3D. Cette technique innovante améliore la précision des mesures cardiaques et permet des décisions thérapeutiques personnalisées.

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Project no. NVKP_16-1&#8211;2016-0017 (&#8217;National Heart Program&#8217;) has been implemented with the support provided from the National Research, Development and Innovation Fund of Hungary, financed under the NVKP_16 funding scheme. The research was financed by the Thematic Excellence Programme (2020-4.1.1.-TKP2020) of the Ministry for Innovation and Technology in Hungary, within the framework of the Therapeutic Development and Bioimaging thematic programmes of the Semmelweis University.

This protocol follows the guidelines of the Semmelweis University Regional and Institutional Committee of Science and Research Ethics. The present protocol applies to a specific vendor. Although some steps remain valid regardless of the ultrasound machine and postprocessing software, important differences may exist if using other vendors&#39; solutions.
1. Technical requirements
<ol>
	<li>Utilize an echocardiography machine capable of 3D imaging.</li>
	<li>Connect a 3D transthoracic echocardiography capable phased array transducer.</li>
	<li>Apply the built-in 3-lead ECG of the ultrasound system to allow the system to synchronize the recordings and analyses to the cardiac cycle.</li>
</ol>
2. Acquisition of the 3D echocardiographic images
<ol>
	<li>Position the patient in the left lateral decubitus position (patient lying on the left side with the left arm stretched above the head).</li>
	<li>Ensure that the ECG tracing on the screen is of good quality. 
	NOTE: This is a prerequisite for postprocessing as the software will detect the different points of the cardiac cycle based on the ECG signal.</li>
	<li>Unfreeze the image, and start to examine the patient with the transducer. Visualize a conventional apical four-chamber view.</li>
	<li>Optimize the image quality by adjusting sector width to LV, lowering the depth to truncate the left atrium, and by using a slight overgain. 
	NOTE: Ensure the entire LV endo- and also the epicardial surface is visible.</li>
	<li>Press the 4D button to switch to 3D mode. 
	NOTE: By pressing the Multi-Slice... button on the touch screen, four options will be available (5, 7, 8, 12 slices) to overview the 3D dataset using standard short- and long axis cuts. If needed, transducer positioning can be corrected to ensure the inclusion of the entire LV wall thickness from apical to mitral valve level into the pyramidal 3D dataset. The use of 12 slices (with nine adjustable short-axis views) is recommended.</li>
	<li>Acquire 3D images using Multi Beat or Single Beat mode.
	<ol>
		<li>Use the Multi Beat mode to achieve higher spatial and temporal resolution, where the dataset will be reconstructed from 2, 3, 4 or 6 cardiac cycles (this can be set-up on the screen) - end-expiratory breath-hold of the patient and stable transducer positioning needed to minimize stitching artifacts. 
		NOTE: Single Beat acquisition is of lower spatial and temporal resolution; however, most modern transducers have better quality and, therefore, can be used to acquire proper 3D datasets without reconstruction to undergo further analysis. As a general recommendation, volume rates over 15 volumes per second are recommended for further analysis.</li>
		<li>When the full-volume is reconstructed from the subvolumes, and the entire LV is visible, freeze the image. Using the Cycle Select and Number of Cycles knobs, select the optimal acquired cardiac cycle(s) and press Image Store. 
		NOTE: Stitching artifacts are spatially or temporarily misaligned subvolumes next to each other. Datasets with a significant dropout of LV walls or with stitching artifacts are generally not suitable for further analysis. The quality of the already acquired 3D dataset can be double-checked using the Multi-Slice mode.</li>
	</ol>
	</li>
</ol>
3. Postprocessing to quantify LV morphology and function
<ol>
	<li>Select a 3D dataset appropriate for further analysis. 
	NOTE: This part of the protocol requires the previously acquired and saved good-quality 3D images and can be performed on the ultrasound machine and a separate workstation, either.</li>
	<li>Click on Measure | Volume, and then select 4D Auto LVQ.</li>
	<li>On the quad-screen (three apical views: four-, two-, and three-chamber views, and one short-axis view, the latter can be adjusted by a horizontal plane on long-axis views), the software asks Modify alignment of apical slices to standard views. If required, correct the apical views manually by tilting and rotation to show the corresponding standard view, thereby eliminating foreshortening. Set tilting to align the caliper with the long axis of the LV by dragging and moving the calipers on long-axis views. Set rotation by the corresponding or the Rotate All knobs on the machine or by adjusting the calipers on the short-axis image. 
	NOTE: Software recommendation can be reset by pushing the Auto Align button.</li>
	<li>After finishing view alignment, click to the next step EDV. The end-diastolic (ED) frame is automatically detected using the ECG signal, but can be manually corrected if necessary.</li>
	<li>Semi-automatic detection of LV endo- and epicardial surface
	<ol>
		<li>Select two landmark points manually on any apical views. Firstly, identify the LV apex and then the middle of the LV base (mitral annulus level) in any apical view. The algorithm will automatically contour the endocardial border of the entire LV. 
		NOTE: There are two more options: Manual, which means that two basal and one apical landmark should be set in every apical view, and Auto Init, which will automatically contour the LV without any user interaction.</li>
		<li>Check contour credibility in three apical views, three short-axis views of different levels, and a fourth user-controlled short axis, to allow visual verification of the detected surface. Contour correction is possible by manually adding points that will then be incorporated in the contour line. 
		NOTE: With Undo, the previously added point can be deleted. Reset button resets the contouring to start the entire section from the beginning. Contour visibility can be adjusted to allow the appreciation of the endocardial surface on the grey-scale image. Endocardial and epicardial contouring should be performed in an accurate and consistent manner. For a detailed recommendation, please check the following reference6.</li>
		<li>Choose the next step, which is the ESV.</li>
		<li>Repeat the same procedure (3.5.1-3.5.2) as mentioned in the previous points to identify and correct the endocardial contour on the end-systolic frame. 
		NOTE: The end-systolic (ES) frame is automatically detected using the ECG signal, but can be manually corrected if necessary. Values of end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), heart rate (HR), stroke volume (SV), cardiac output (CO) and sphericity index (SpI) are already displayed on the screen.</li>
		<li>Press Volume waveform for the next step. The software displays a dynamic 3D model of the LV and also time-volume curve as it traces the endocardial surface throughout the cardiac cycle frame-by-frame (Figure 1). 
		NOTE: Here, there is a possibility to edit the endocardial border at any frame.</li>
		<li>For the next step, press LV Mass. The software automatically contours LV epicardial contour on the end-diastolic frame and calculates LV mass (EDMass). 
		NOTE: If necessary, edit the contour of the epicardial surface by adding points to include (same method as previously described) in any short- or long-axis plane. It can be selected which contour to adjust: Endo, Epi, or Endo+Epi.</li>
		<li>Press 4D Strain ROI for the next step. The software automatically contours LV epicardial contour on the end-systolic frame and calculates LV end-systolic mass (ESMass). 
		NOTE: If necessary, edit the end-systolic contour of the epicardial surface by adding points to include (same method as previously described) in any short- or long-axis plane. ESMass should be of similar value than EDMass. This step is essential to calculate 3D strain values by speckle tracking.</li>
		<li>Press 4D Strain Results for the next step. The software visualizes the 3D myocardial tracking on multiple short- and long-axis planes and corresponding strain values of the 17 standard LV segments throughout the cardiac cycle, frame-by-frame. Time-strain curves and bull&#39;s eye plot are also displayed. The following parameters are calculated and can be demonstrated: longitudinal strain, circumferential strain, radial strain, area strain, rotation, and torsion. 
		NOTE: There is a possibility to exclude a particular LV segment from analysis if it is considered as having a low tracking quality by visual observation of images or based on the time-strain curve. However, the software recommends by default on segment approval or rejection. Color-coded strain values can be visualized on a dynamic 3D model of the LV by changing the &#34;Layout&#34;.</li>
	</ol>
	</li>
	<li>To terminate the analysis, press Approve &#38; Exit.</li>
</ol>

<ol><li>Guta, A. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Three-dimensional+echocardiography+to+assess+left+ventricular+geometry+and+function%5BTitle%5D)+AND+%22Expert+Review+of+Cardiovascular+Therapy%22%5BJournal%5D)">Three-dimensional echocardiography to assess left ventricular geometry and function.</a> Expert Review of Cardiovascular Therapy. 17 (11), 801-815 (2019).</li>
<li>Surkova, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Current+Clinical+Applications+of+Three-Dimensional+Echocardiography%3A+When+the+Technique+Makes+the+Difference%5BTitle%5D)+AND+%22Current+Cardiology+Reports%22%5BJournal%5D)">Current Clinical Applications of Three-Dimensional Echocardiography: When the Technique Makes the Difference.</a> Current Cardiology Reports. 18 (11), 109(2016).</li>
<li>Lang, R. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Recommendations+for+cardiac+chamber+quantification+by+echocardiography+in+adults%3A+an+update+from+the+American+Society+of+Echocardiography+and+the+European+Association+of+Cardiovascular+Imaging%5BTitle%5D)+AND+%22Journal+of+the+American+Society+of+Echocardiography%22%5BJournal%5D)">Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.</a> Journal of the American Society of Echocardiography. 28 (1), 1-39 (2015).</li>
<li>Matyas, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Comparison+of+speckle-tracking+echocardiography+with+invasive+hemodynamics+for+the+detection+of+characteristic+cardiac+dysfunction+in+type-1+and+type-2+diabetic+rat+models%5BTitle%5D)+AND+%22Cardiovascular+Diabetology%22%5BJournal%5D)">Comparison of speckle-tracking echocardiography with invasive hemodynamics for the detection of characteristic cardiac dysfunction in type-1 and type-2 diabetic rat models.</a> Cardiovascular Diabetology. 17 (1), 13(2018).</li>
<li>Kovacs, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Impact+of+hemodialysis%2C+left+ventricular+mass+and+FGF-23+on+myocardial+mechanics+in+end-stage+renal+disease%3A+a+three-dimensional+speckle+tracking+study%5BTitle%5D)+AND+%22International+Journal+of+Cardiovascular+Imaging%22%5BJournal%5D)">Impact of hemodialysis, left ventricular mass and FGF-23 on myocardial mechanics in end-stage renal disease: a three-dimensional speckle tracking study.</a> International Journal of Cardiovascular Imaging. 30 (7), 1331-1337 (2014).</li>
<li>Muraru, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Comprehensive+analysis+of+left+ventricular+geometry+and+function+by+three-dimensional+echocardiography+in+healthy+adults%5BTitle%5D)+AND+%22Journal+of+the+American+Society+of+Echocardiography%22%5BJournal%5D)">Comprehensive analysis of left ventricular geometry and function by three-dimensional echocardiography in healthy adults.</a> Journal of the American Society of Echocardiography. 26 (6), 618-628 (2013).</li>
<li>Lakatos, B. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Relationship+between+Cardiac+Remodeling+and+Exercise+Capacity+in+Elite+Athletes%3A+Incremental+Value+of+Left+Atrial+Morphology+and+Function+Assessed+by+Three-Dimensional+Echocardiography%5BTitle%5D)+AND+%22Journal+of+the+American+Society+of+Echocardiography%22%5BJournal%5D)">Relationship between Cardiac Remodeling and Exercise Capacity in Elite Athletes: Incremental Value of Left Atrial Morphology and Function Assessed by Three-Dimensional Echocardiography.</a> Journal of the American Society of Echocardiography. 33 (1), 101-109 (2020).</li>
<li>Muraru, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Intervendor+Consistency+and+Accuracy+of+Left+Ventricular+Volume+Measurements+Using+Three-Dimensional+Echocardiography%5BTitle%5D)+AND+%22Journal+of+the+American+Society+of+Echocardiography%22%5BJournal%5D)">Intervendor Consistency and Accuracy of Left Ventricular Volume Measurements Using Three-Dimensional Echocardiography.</a> Journal of the American Society of Echocardiography. 31 (2), 158-168 (2018).</li>
<li>Kalam, K., Otahal, P., Marwick, T. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Prognostic+implications+of+global+LV+dysfunction%3A+a+systematic+review+and+meta-analysis+of+global+longitudinal+strain+and+ejection+fraction%5BTitle%5D)+AND+%22Heart%22%5BJournal%5D)">Prognostic implications of global LV dysfunction: a systematic review and meta-analysis of global longitudinal strain and ejection fraction.</a> Heart. 100 (21), 1673-1680 (2014).</li>
<li>Muraru, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Validation+of+a+novel+automated+border-detection+algorithm+for+rapid+and+accurate+quantitation+of+left+ventricular+volumes+based+on+three-dimensional+echocardiography%5BTitle%5D)+AND+%22European+Journal+of+Echocardiography%22%5BJournal%5D)">Validation of a novel automated border-detection algorithm for rapid and accurate quantitation of left ventricular volumes based on three-dimensional echocardiography.</a> European Journal of Echocardiography. 11 (4), 359-368 (2010).</li>
<li>Doronina, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((The+Female+Athlete%27s+Heart%3A+Comparison+of+Cardiac+Changes+Induced+by+Different+Types+of+Exercise+Training+Using+3D+Echocardiography%5BTitle%5D)+AND+%22BioMed+Research+International%22%5BJournal%5D)">The Female Athlete's Heart: Comparison of Cardiac Changes Induced by Different Types of Exercise Training Using 3D Echocardiography.</a> BioMed Research International. 2018, 3561962(2018).</li>
<li>Takeuchi, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Measurement+of+left+ventricular+mass+by+real-time+three-dimensional+echocardiography%3A+validation+against+magnetic+resonance+and+comparison+with+two-dimensional+and+m-mode+measurements%5BTitle%5D)+AND+%22Journal+of+the+American+Society+of+Echocardiography%22%5BJournal%5D)">Measurement of left ventricular mass by real-time three-dimensional echocardiography: validation against magnetic resonance and comparison with two-dimensional and m-mode measurements.</a> Journal of the American Society of Echocardiography. 21 (9), 1001-1005 (2008).</li>
<li>Armstrong, A. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((LV+mass+assessed+by+echocardiography+and+CMR%2C+cardiovascular+outcomes%2C+and+medical+practice%5BTitle%5D)+AND+%22JACC+Cardiovasc+Imaging%22%5BJournal%5D)">LV mass assessed by echocardiography and CMR, cardiovascular outcomes, and medical practice.</a> JACC Cardiovasc Imaging. 5 (8), 837-848 (2012).</li>
<li>Olah, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Characterization+of+the+dynamic+changes+in+left+ventricular+morphology+and+function+induced+by+exercise+training+and+detraining%5BTitle%5D)+AND+%22International+Journal+of+Cardiology%22%5BJournal%5D)">Characterization of the dynamic changes in left ventricular morphology and function induced by exercise training and detraining.</a> International Journal of Cardiology. 277, 178-185 (2019).</li>
<li>Nagy, V. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Role+of+Right+Ventricular+Global+Longitudinal+Strain+in+Predicting+Early+and+Long-Term+Mortality+in+Cardiac+Resynchronization+Therapy+Patients%5BTitle%5D)+AND+%22PLoS+One%22%5BJournal%5D)">Role of Right Ventricular Global Longitudinal Strain in Predicting Early and Long-Term Mortality in Cardiac Resynchronization Therapy Patients.</a> PLoS One. 10 (12), e0143907(2015).</li>
<li>Kovacs, A., Lakatos, B., Tokodi, M., Merkely, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Right+ventricular+mechanical+pattern+in+health+and+disease%3A+beyond+longitudinal+shortening%5BTitle%5D)+AND+%22Heart+Failure+Reviews%22%5BJournal%5D)">Right ventricular mechanical pattern in health and disease: beyond longitudinal shortening.</a> Heart Failure Reviews. 24 (4), 511-520 (2019).</li>
<li>Badano, L. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Use+of+three-dimensional+speckle+tracking+to+assess+left+ventricular+myocardial+mechanics%3A+inter-vendor+consistency+and+reproducibility+of+strain+measurements%5BTitle%5D)+AND+%22European+Heart+Journal+-+Cardiovascular+Imaging%22%5BJournal%5D)">Use of three-dimensional speckle tracking to assess left ventricular myocardial mechanics: inter-vendor consistency and reproducibility of strain measurements.</a> European Heart Journal - Cardiovascular Imaging. 14 (3), 285-293 (2013).</li>
</ol>

LV morphological and functional measurements represent cornerstones of diagnosis, management, and follow-up of cardiac diseases; moreover, they are powerful predictors of outcome. Generally, 2D echocardiography-based evaluation of the LV is recommended by current practice guidelines; however, 3D echocardiography has been proven to be more accurate as it is free from geometrical assumptions concerning LV shape7,8. Deformation imaging by speckle tracking is a robus...

The assessment of left ventricular (LV) morphology and function is the predominant purpose of general and even more specific investigations in cardiology1. The widely available and noninvasive transthoracic echocardiography (TTE), which can provide dense amounts of information, is the method of choice for a convenient, fast, and cost-effective evaluation.
Measurement of LV mass, volumes, and subsequent ejection fraction holds significant diagnostic and also prognostic value2. The more accurate a given measure is, the higher its value will be. A better correlation with gold standard cardiac magnetic resonance (CMR) imaging derived values is an ongoing chase for echocardiographic techniques. Generally, clinical practice guidelines recommend the biplane Simpson&#39;s method for LV volume and ejection fraction measurement3. However, the LV is a three-dimensional (3D) structure with an often irregular shape, and therefore, several tomographic planes will undoubtedly fail in some clinical scenarios to accurately delineate LV morphology and function. Recent advancements in ultrasonic hardware and software technology permitted the development of real-time 3D imaging, which revolutionalizes echocardiographic protocols.
Moreover, the need for a quantitative approach concerning wall motion abnormalities resulted in the rise of deformation imaging4. Strain and strain rate parameters can be calculated by speckle tracking using standard grey-scale images. 3D echocardiography may also overcome several shortcomings of a two-dimensional strain assessment5. From an expensive scientific tool, 3D echocardiography started to become a powerful technique used in everyday clinical practice, and the quantification of the LV is certainly in the first line in this breakthrough.
The present article aims to guide the reader through a detailed 3D protocol by presenting tips and tricks and also by highlighting the potential pitfalls to facilitate the widespread but technically sound use of this important technique concerning the LV.

<table><tbody><tr><td>3V-D/4V-D/4Vc-D</td><td>General Electric</td><td>n.a.</td><td>ultrasound probe</td></tr><tr><td>4D Auto LVQ</td><td>General Electric</td><td>n.a.</td><td>software for analysis</td></tr><tr><td>E9/E95</td><td>General Electric</td><td>n.a.</td><td>ultrasound machine</td></tr><tr><td>EchoPac v203</td><td>General Electric</td><td>n.a.</td><td>software for analysis</td></tr></tbody></table>

evaluation of left ventricular structure and function using 3d echocardiography

Evaluation of Left Ventricular Structure and Function using 3D Echocardiography

Three-dimensional (3D) quantification of the left ventricle (LV) provides significant added value in terms of diagnostic accuracy and precise risk stratification in various cardiac disorders. Recently, 3D echocardiography became available in routine cardiology practice; however, high-quality image acquisition and subsequent analysis have a steep learning curve. The present article aims to guide the reader through a detailed 3D protocol by presenting tips and tricks and also by highlighting the potential pitfalls to facilitate the widespread but technically sound use of this important technique concerning the LV. First and foremost, we show the acquisition of a high-quality 3D dataset with optimal spatial and temporal resolution. Then, we present the analytical steps toward a detailed quantification of the LV by using one of the most widely applied built-in software. We will quantify LV volumes, sphericity, mass and also systolic function by measuring ejection fraction and myocardial deformation (longitudinal and circumferential strain). We will discuss and provide clinical examples about the essential scenarios where the transition from a conventional echocardiographic approach to a 3D-based quantification is highly recommended.

3D analysis of the LV is feasible in the majority of patients. Case 1 is a healthy volunteer with normal ventricular volumes and function (Figure 1). Case 2 (Figure 2) is a 64-year old male patient with dilated cardiomyopathy and a wide QRS complex (160 ms) of left bundle branch block morphology. Gold standard CMR measurements were the following: end-diastolic volume: 243 mL, end-systolic volume: 160 mL, ejection fraction: 34%, L...

In this article, we provide a step-by-step acquisition and analysis protocol for the volumetric assessment and speckle-tracking analysis of the left ventricle by 3D echocardiography, particularly focusing on practical aspects that maximize the feasibility of this technique.

Three-dimensional (3D) quantification of the left ventricle (LV) provides significant added value in terms of diagnostic accuracy and precise risk ...

3D echocardiographic assessment of cardiac structure and function, is a breakthrough innovation in cardiology. Quantification of left ventricle morphology and systolic performance, is the single most important step in every echocardiographic protocol. 3D echocardiographic-derived left ventricular volumes and ejection fraction correlate the most with core standard cardiac MRI and have shown to be more reproducible compared with conventional 2D techniques.More accurate results, turn into more tailored therapeutic decisions and that the end of the day, better patient outcomes. The scientific and clinical success of 3D based left ventricle assessment, paves the way to apply a similar technique to other cardiac structures such as right ventricle, the atria or even the valves. Proper image acquisition, followed by a comprehensive critical image analysis are the prerequisites for adequate use and accurate measurements.Our video article provides a step-by-step guide to achieve this. For the acquisition of 3D echocardiographic images, position the patient in the left lateral decubitus position and confirm that the ECG tracing on the screen is of good quality. Unfreeze the image and begin to

evaluation-left-ventricular-structure-function-using-3d

Research

JoVE Journal

Bioengineering

Transthoracic echocardiography offers a noninvasive method for the evaluation of cardiac function in mice. A combination of ultrasound and Doppler imaging modalities can be used to obtain dimensional measurements of the heart and intracardiac blood flow, which together provide an assessment of cardiac systolic and diastolic performance.

Transthoracic Echocardiography in Mice

Right ventricle (RV) dysfunction is critical to the pathogenesis of cardiovascular disease, yet limited methodologies are available for its evaluation. Recent advances in ultrasound imaging provide a noninvasive and accurate option for longitudinal RV study. Herein, we detail a step-by-step echocardiographic method using a murine model of RV pressure overload.

Assessment of Right Ventricular Structure and Function in Mouse Model of Pulmonary Artery Constriction by Transthoracic Echocardiography

This protocol provides a detailed description of the echocardiographic approach for comprehensive phenotyping of heart and heart valve function in mice.

Echocardiographic Approaches and Protocols for Comprehensive Phenotypic Characterization of Valvular Heart Disease in Mice

The following protocol describes the methodology for the acquisition and analysis of echocardiographic images used to obtain the Left Atrial Volume (LAV), Aorta (Ao) diameter, and Pulmonary Artery (PA) diameter in mice. This technique is a non-invasive, non-terminal procedure that allows assessment of the cardiopulmonary function.

Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery

A non-invasive protocol for transthoracic echocardiography assessment of cardiac anatomy and function for adult rats is presented in the current study. The heart valves, all four cardiac chambers and the ascending aorta, aortic arch and descending aorta are studied in detail.

Echocardiographic Assessment of Cardiac Anatomy and Function in Adult Rats

Here, we provide a step-by-step acquisition and analysis protocol for the 3D volumetric assessment of the right ventricle, mainly focusing on the practical aspects that maximize the feasibility of this technique.

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography

The dimensions of the pulmonary veins (PV) are important parameters when planning pulmonary vein isolation. 2D transoesophageal echocardiography can only provide limited data about the PVs; however, 3D echocardiography can evaluate relevant diameters and areas of the PVs, as well as their spatial relationship to surrounding structures.

Three-Dimensional Echocardiographic Method for the Visualization and Assessment of Specific Parameters of the Pulmonary Veins

Accurate intracardiac echocardiography (ICE) shows significant accuracy in estimating the left atrial structure, a prospective and promising cardiac structure estimation method. Here we propose a protocol for three-dimensional modeling of the left atrium and pulmonary veins with ICE and fast anatomical mapping (FAM) catheter remodeling.

Three-Dimensional Modeling of the Left Atrium and Pulmonary Veins with a Precise Intracardiac Echocardiography Approach

Measuring left ventricular pressure (LV) in embryonic and neonatal mice is described. Pressure is measured by inserting a needle connected to a fluid-filled transducer into the LV under ultrasound guidance. Care must be taken to maintain normal cardiac function during the experimental protocol.

Measuring Left Ventricular Pressure in Late Embryonic and Neonatal Mice

A methodology to estimate ventricular fiber orientations from in vivo images of patient heart geometries for personalized modeling is described. Validation of the methodology performed using normal and failing canine hearts demonstrate that that there are no significant differences between estimated and acquired fiber orientations at a clinically observable level.

Patient-specific Modeling of the Heart: Estimation of Ventricular Fiber Orientations

Apprenez l'évaluation volumétrique et le speckle-tracking du ventricule gauche par échocardiographie 3D. Cette technique innovante améliore la précision des mesures cardiaques et permet des décisions thérapeutiques personnalisées.

Evaluation of Left Ventricular Structure and Function using 3D Echocardiography

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