Non-invasive myocardial performance mapping using 3D echocardiographic stress-strain loops

Area of Science:

• Cardiovascular Imaging
• Biomedical Engineering
• Medical Physics

Background:

• Assessing regional left ventricular (LV) ejection is clinically vital but challenging.
• Current deformation imaging methods do not account for loading conditions.
• Non-invasive intraventricular pressure estimation allows consideration of loading conditions.

Purpose of the Study:

• To develop and validate a 3D automatic myocardial performance mapping method using echocardiography.
• To assess local LV stress-strain relationships as a measure of myocardial work.
• To correlate this novel method with 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) for local metabolism.

Main Methods:

• 3D automatic myocardial segmentation and tracking in echocardiography.
• Calculation of local geometry and strain from segmented data.
• Estimation of local LV stress-strain relationships and myocardial work.

Main Results:

• The proposed 3D echocardiography method provides access to local geometry and strain.
• Local LV stress-strain relationships were estimated, representing local myocardial work.
• A strong correlation was observed between the proposed method and FDG-PET (gold standard for metabolism).

Conclusions:

• Stress-strain loops were successfully estimated from 3D echocardiography for the first time.
• The method demonstrates significant potential for non-invasive assessment of local myocardial metabolic activity.
• Real-time 3D echocardiography (RT3DE) may offer a future tool for evaluating cardiac metabolic function.