The applicants have developed and tested, on various manufacturers' echocardiography equipment, a model-based image processing (MBIP) method for the analysis of diastolic transmitral Doppler flow velocity images. The method can extract quantitative physiologic information from transmitral Doppler echocardiographic images that previously could not be obtained or could only be determined by cardiac catheterization. The proposed research follows two main, interconnected themes: I) refinement of the MBIP method and, II) in-vivo verification. Specifically, the following MBIP steps will be refined: 1) machine independent Doppler image acquisition via video frame-grabbing, 2) extraction of the maximum velocity contour, and 3) fit solution of LV filling model to the contour using digital processing, estimation theory and error minimization. The in-vivo component will test the hypothesis that physiologically relevant, non-invasive quantitation of DF can be achieved by this MBIP method. MBIP advantages, in comparison to available methods of Doppler analysis include: 1) echo machine independent, numerically determined, rather than hand-traced/hand-digitized Doppler velocity contours, 2) causal, rather than correlative modeling, 3) unique-valued model parameters determined by numerical (automated) means directly from Doppler images, 4) noninvasive determination of DF parameters previously requiring catheterization. The proposed research will identify physiologic DF parameters obtained by transmitral Doppler echocardiography, and verify them, by simultaneous left and right heart catheterization in subjects meeting inclusionary criteria.
The Specific Aims are to: 1) refine and extend the MBIP method for cardiac diastolic Doppler analysis, 2) validate the relation between MBIP-derived and invasively-derived indices of DF by analysis of simultaneous diastolic Doppler and high-fidelity hemodynamic data and MBIP based predictions, 3) verify the physiologic analogues of MBIP parameters as clinically relevant Doppler-derived indexes of DF.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL054179-02
Application #
2750469
Study Section
Special Emphasis Panel (ZRG7-DMG (01))
Project Start
1997-08-13
Project End
2000-07-31
Budget Start
1998-08-01
Budget End
1999-07-31
Support Year
2
Fiscal Year
1998
Total Cost
Indirect Cost
Name
Barnes-Jewish Hospital
Department
Type
DUNS #
City
Saint Louis
State
MO
Country
United States
Zip Code
63110
Riordan, Matt M; Weiss, Edward P; Meyer, Timothy E et al. (2008) The effects of caloric restriction- and exercise-induced weight loss on left ventricular diastolic function. Am J Physiol Heart Circ Physiol 294:H1174-82
Boskovski, Marko T; Shmuylovich, Leonid; Kovacs, Sandor J (2008) Transmitral flow velocity-contour variation after premature ventricular contractions: a novel test of the load-independent index of diastolic filling. Ultrasound Med Biol 34:1901-8
Chung, Charles S; Kovacs, Sandor J (2008) Physical determinants of left ventricular isovolumic pressure decline: model prediction with in vivo validation. Am J Physiol Heart Circ Physiol 294:H1589-96
Riordan, Matt M; Kovacs, Sandor J (2008) Elucidation of spatially distinct compensatory mechanisms in diastole: radial compensation for impaired longitudinal filling in left ventricular hypertrophy. J Appl Physiol 104:513-20
Zhang, Wei; Chung, Charles S; Riordan, Matt M et al. (2007) The kinematic filling efficiency index of the left ventricle: contrasting normal vs. diabetic physiology. Ultrasound Med Biol 33:842-50
Chung, Charles S; Kovacs, Sandor J (2007) Pressure phase-plane based determination of the onset of left ventricular relaxation. Cardiovasc Eng 7:162-71
Riordan, Matt M; Kovacs, Sandor J (2007) Stiffness- and relaxation-based quantitation of radial left ventricular oscillations: elucidation of regional diastolic function mechanisms. J Appl Physiol 102:1862-70
Riordan, Matt M; Kovacs, Sandor J (2007) Absence of diastolic mitral annular oscillations is a marker for relaxation-related diastolic dysfunction. Am J Physiol Heart Circ Physiol 292:H2952-8
Shmuylovich, Leonid; Kovacs, Sandor J (2007) E-wave deceleration time may not provide an accurate determination of LV chamber stiffness if LV relaxation/viscoelasticity is unknown. Am J Physiol Heart Circ Physiol 292:H2712-20
Wu, Yue; Yu, Yingbo; Kovacs, Sandor J (2007) Contraction-relaxation coupling mechanism characterization in the thermodynamic phase plane: normal vs. impaired left ventricular ejection fraction. J Appl Physiol 102:1367-73

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