Technology for imaging the heart has advanced dramatically in recent years. In particular, real-time three-dimensional ultrasound (RT3D) has captured the imagination of cardiologists with its ability to obtain complete three-dimensional images of the heart over an entire cardiac cycle in just a few seconds of imaging. The wealth of information contained in such fully four-dimensional (3D plus time) cardiac images could greatly enhance clinical diagnosis, but so far it remains largely inaccessible to clinicians. The goal of this proposal is to provide a set of practical methods for extracting information from these large datasets, reducing it to quantitative, diagnostically useful measures, and presenting this information in a simple, straightforward way, all within a time frame consistent with the time demands of clinical practice. Achievement of this goal will unleash for the first time the true diagnostic power of 4D cardiac imaging. In particular, this proposal will focus on a common problem for which 4D cardiac imaging is ideally suited: screening for regions of acute ischemia (insufficient blood flow) that indicate the presence of coronary artery disease.
The specific aims of this proposal are: (1) to test the hypothesis that reduced three-dimensional fractional shortening (3DFS) predicts the size and location of experimentally induced acutely ischemic regions with better accuracy than the current state of the art, segment scoring by expert cardiologists;(2) to test the hypothesis that reduced three-dimensional fractional shortening (3DFS) during dobutamine stress detects and localizes regions of angiographically confirmed coronary artery disease with better accuracy than analysis by expert cardiologists;(3) to test the hypothesis that optical flow tracking from a single manually digitized frame provides endocardial surface data for the full cardiac cycle with similar accuracy to fully manual digitizing;and (4) to use a model-based process to develop new customized 4D wall motion measures to improve quantification of the size, location, and severity of acutely ischemic regions. The significance of the proposed work is that it will provide the most accurate, least labor-intensive measures of ventricular wall motion developed to date, finally allowing clinicians to routinely measure wall motion, rather than simply assessing it qualitatively.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
Project #
Application #
Study Section
Biomedical Imaging Technology Study Section (BMIT)
Program Officer
Buxton, Denis B
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Virginia
Biomedical Engineering
Schools of Engineering
United States
Zip Code
Parker, Katherine M; Clark, Alexander P; Goodman, Norman C et al. (2015) Comparison of quantitative wall-motion analysis and strain for detection of coronary stenosis with three-dimensional dobutamine stress echocardiography. Echocardiography 32:349-60
Parker, Katherine M; Bunting, Ethan; Malhotra, Rohit et al. (2014) Postprocedure mapping of cardiac resynchronization lead position using standard fluoroscopy systems: implications for the nonresponder with scar. Pacing Clin Electrophysiol 37:757-67
Bilchick, Kenneth C; Kuruvilla, Sujith; Hamirani, Yasmin S et al. (2014) Impact of mechanical activation, scar, and electrical timing on cardiac resynchronization therapy response and clinical outcomes. J Am Coll Cardiol 63:1657-66
Moyer, Christian B; Helm, Patrick A; Clarke, Christopher J et al. (2013) Wall-motion based analysis of global and regional left atrial mechanics. IEEE Trans Med Imaging 32:1765-76
Herz, Susan L; Hasegawa, Takuya; Makaryus, Amgad N et al. (2010) Quantitative three-dimensional wall motion analysis predicts ischemic region size and location. Ann Biomed Eng 38:1367-76
Duan, Qi; Parker, Katherine M; Lorsakul, Auranuch et al. (2009) QUANTITATIVE VALIDATION OF OPTICAL FLOW BASED MYOCARDIAL STRAIN MEASURES USING SONOMICROMETRY. Proc IEEE Int Symp Biomed Imaging 2009:454-457
Duan, Qi; Angelini, Elsa D; Herz, Susan L et al. (2009) Region-based endocardium tracking on real-time three-dimensional ultrasound. Ultrasound Med Biol 35:256-65
Duan, Qi; Angelini, Elsa D; Lorsakul, Auranuch et al. (2009) Coronary Occlusion Detection with 4D Optical Flow Based Strain Estimation on 4D Ultrasound. Lect Notes Comput Sci 5528:211-219