? The objective of this project is to develop a Windows-based software system that allows clinicians to apply advanced mathematical modeling capabilities to characterize myocardial mechanics. The prototype software developed during the Phase I project provides the framework for this development. The input required by the system consists of: (1) the digitized representation of multiple layer short-axis and long-axis magnetic resonance imaging (MRI) scans of the heart, with and without radio frequency tissue-tagging; (2) noninvasive, digitized carotid artery pulse pressure obtained at the bedside or invasively obtained pressure through intracardiac catheter (IC). This information is compiled as MRI-based 3D geometrical data sets, 3D myocardial displacement data sets, and calibrated systolic loading data sets. The output from the system is directed toward two separate clinical solutions: (1) global and regional left ventricular stress calculation based upon a finite element solution utilizing patient-specific left ventricular geometry and the corresponding intracavitary loads; (2) left ventricular regional strain characterization based upon regional determination of both quantified circumferential minimum principal strain and minimum principal strain vector determination at baseline and during low dose Dobutamine (viability) and high dose Dobutamine (ischemia/myocardial infartation) infusion. The completion of the Phase I activities resulted in a prototype software package designed to interact with MRI data sets allowing clinicians, who wish to utilize the unparalleled power of advanced engineering analysis in making difficult therapeutic decisions, to have that information presented in a user-friendly format.
The aims of the Phase II project are: (1) the further development of the capabilities of the prototype software; (2) its integration with the Unix-based MRI imaging data acquisition system currently utilized by the research institution to produce a stand-alone clinical tool; (3) the analysis of patient data to determine normality ranges of the information obtained from the Strain and Stress analyses to provide the necessary guidelines for the effective utilization of the tool. Software that would enable a noninvasive regional analysis of biventricular function would be combined with other software (some of which is already available) to enable coronary arterial and valvular imaging, providing the most comprehensive cardiac analysis package available. ? ?
