title: Open-source, vendor-independent, automated multi-beat tissue Doppler echocardiography analysis.
abstract: Current guidelines for measuring cardiac function by tissue Doppler recommend using multiple beats, but this has a time cost for human operators. We present an open-source, vendor-independent, drag-and-drop software capable of automating the measurement process. A database of ~8000 tissue Doppler beats (48 patients) from the septal and lateral annuli were analyzed by three expert echocardiographers. We developed an intensity- and gradient-based automated algorithm to measure tissue Doppler velocities. We tested its performance against manual measurements from the expert human operators. Our algorithm showed strong agreement with expert human operators. Performance was indistinguishable from a human operator: for algorithm, mean difference and SDD from the mean of human operators' estimates 0.48 ± 1.12 cm/s (R2= 0.82); for the humans individually this was 0.43 ± 1.11 cm/s (R2= 0.84), -0.88 ± 1.12 cm/s (R2= 0.84) and 0.41 ± 1.30 cm/s (R2= 0.78). Agreement between operators and the automated algorithm was preserved when measuring at either the edge or middle of the trace. The algorithm was 10-fold quicker than manual measurements (p < 0.001). This open-source, vendor-independent, drag-and-drop software can make peak velocity measurements from pulsed wave tissue Doppler traces as accurately as human experts. This automation permits rapid, bias-resistant multi-beat analysis from spectral tissue Doppler images.
authors.affiliation: National Heart and Lung Institute, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK. nitidhutia@gmail.com.
authors.forename: Niti M
authors.initials: NM
authors.lastname: Dhutia
authors.affiliation: National Heart and Lung Institute, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK.
authors.forename: Massoud
authors.initials: M
authors.lastname: Zolgharni
authors.affiliation: National Heart and Lung Institute, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Mielewczik
authors.affiliation: National Heart and Lung Institute, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK.
authors.forename: Madalina
authors.initials: M
authors.lastname: Negoita
authors.affiliation: National Heart and Lung Institute, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK.
authors.forename: Stefania
authors.initials: S
authors.lastname: Sacchi
authors.affiliation: National Heart and Lung Institute, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK.
authors.forename: Karikaran
authors.initials: K
authors.lastname: Manoharan
authors.affiliation: National Heart and Lung Institute, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK.
authors.forename: Darrel P
authors.initials: DP
authors.lastname: Francis
authors.affiliation: National Heart and Lung Institute, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK.
authors.forename: Graham D
authors.initials: GD
authors.lastname: Cole
mesh_terms: D000368:Aged; D000465:Algorithms; D001331:Automation; D055424:Cardiac-Gated Imaging Techniques; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods*; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012984:Software; D016277:Ventricular Function, Left
keywords: Automated; Echocardiography; Myocardial velocities; Tissue Doppler; Vendor-independent measurements