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Echocardiographic quantification of left ventricular asynergy in coronary artery disease with Fourier phase imaging
A Hansen1, C Krueger, S E Hardt
1Department of Cardiology, University of Heidelberg, Germany. alexander_hansen@gmx.de
Insights
Fourier phase imaging objectively quantifies left ventricular asynchrony, an indicator of myocardial dysfunction in coronary artery disease. This method provides a simple, accurate assessment of regional wall motion abnormalities.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Visual assessment of left ventricular wall motion is subjective and challenging in patients with reduced ejection fraction.
- Existing wall motion analysis algorithms often overlook motion asynchrony, a key feature in coronary artery disease.
- Left ventricular asynergy's role in quantifying regional myocardial dysfunction requires further investigation.
Purpose of the Study:
- To determine if left ventricular asynergy, analyzed via Fourier phase imaging, can quantify regional myocardial dysfunction severity.
- To evaluate the utility of Fourier phase imaging in assessing wall motion abnormalities.
Main Methods:
- Echocardiographic cine loops from 21 patients with ischemic cardiomyopathy (ejection fraction ≤ 40%) were analyzed.
- A first-harmonic Fourier algorithm transformed echocardiograms into parametric images and regional phase histograms.
- Segmental fractional area shortening (FAC) and visual wall motion assessment served as the reference methods.
Main Results:
- An inverse linear relationship was observed between FAC and phase angles (r = -0.75, p < 0.01).
- Normal wall motion showed low phase angles (mean 16 ± 15 degrees).
- Phase angles progressively increased with wall motion abnormalities: hypokinetic (56 ± 38 degrees), akinetic (88 ± 38 degrees), and dyskinetic (143 ± 33 degrees, p < 0.001).
Conclusions:
- Left ventricular asynchrony is a significant indicator of regional myocardial dysfunction in coronary artery disease.
- Echocardiographic Fourier phase imaging offers an objective and simple method to quantify wall motion and contraction sequence.
- This technique enhances the assessment of myocardial function in ischemic heart disease.
Background:
Visual evaluation of wall motion is subjective and may be difficult in patients with impaired left ventricular function. Current algorithms used to analyze wall motion usually neglect motion asynchrony that may be profoundly altered in coronary artery disease. This study was to investigate whether the extent of left ventricular asynergy can be used to quantify the severity of regional myocardial dysfunction by the use of Fourier phase imaging.
Methods:
Echocardiographic cine loops of 21 patients with ischemic cardiomyopathy (EF < or = 40%) were mathematically transformed using a first-harmonic Fourier algorithm displaying the sequence of wall motion as phase angles in parametric images and regional phase histograms. Segmental fractional area shortening (FAC) and qualitative assessment of regional wall motion based on visual inspection served as reference method.
Results:
There was an inverse linear relationship between FAC and phase angles (r = -0.75, p < 0.01). Normal endocardial motion yielded low phase angles (mean 16 +/- 15 degrees SD). With an increase in wall motion abnormalities, phase angles were progressively delayed by 56 +/- 38 degrees in hypokinetic, by 88 +/- 38 degrees in akinetic, and by 143 +/- 33 degrees (p < 0.001) in dyskinetic segments.
Conclusions:
These results demonstrate that left ventricular asynchrony is an indicator of regional myocardial dysfunction in coronary artery disease. Echocardiographic Fourier phase imaging can be used to quantify wall motion displaying contraction sequence in a simple and objective format.