Atlas-based quantification of myocardial motion abnormalities: added-value for understanding the effect of cardiac resynchronization therapy.
Statistical atlases may help improving the analysis of cardiac wall-motion abnormalities. This study aims at demonstrating the clinical value of such a method to better understand the effect of cardiac resynchronization therapy (CRT). We compared an atlas of normal septal motion built using apical four-chamber two-dimensional echocardiographic sequences from healthy volunteers with 88 patients undergoing CRT at baseline and at 12 months follow-up. Abnormal motion was quantified locally using a p value based on a statistical distance to normality. Reduction ≥15% in left ventricle end-systolic volume defined CRT response. Responders showed significantly higher reduction of abnormalities (p ≤ 0.001). Non-responders conserved abnormal septal motion at the end of the isovolumic contraction (IVC). A specific inward-outward motion of the septum during IVC predominated in responders and was corrected at follow-up. The method is of interest to characterize patterns of mechanical dyssynchrony and to study the link between their evolution and CRT response.
Center for Computational Imaging and Simulation Technologies in Biomedicina, Universitat Pompeu Fabra and Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina, Barcelona, Spain. n.duchateaucistib@gmail.com
Nicolas
N
Duchateau
Adelina
A
Doltra
Etelvino
E
Silva
Mathieu
M
De Craene
Gemma
G
Piella
Maria Ángeles
MÁ
Castel
Lluís
L
Mont
Josep
J
Brugada
Alejandro F
AF
Frangi
Marta
M
Sitges
D000328:Adult; D000368:Aged; D058406:Cardiac Resynchronization Therapy; D004452:Echocardiography; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging