LEFT VENTRICULAR EJECTION FRACTION: COMPARISON BETWEEN TRUE VOLUME-BASED MEASUREMENTS AND AREA-BASED ESTIMATES.
LEFT VENTRICULAR EJECTION FRACTION: COMPARISON BETWEEN TRUE VOLUME-BASED MEASUREMENTS AND AREA-BASED ESTIMATES.
复制标题
左心室射血分数：基于真实体积的测量值和基于面积的估计值之间的比较。
DOI：
10.1109/wnyipw.2018.8576438
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Linte,CristianA
中科院分区：
文献类型：
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作者：
Liu,Dawei;Peck,Isabelle;Dangi,Shusil;Schwarz,KarlQ;Linte,CristianA
左心室射血分数（LVEF）是临床实践中常用的心脏健康的关键指标，是心血管治疗的基础。心脏超声（US）成像是评估LVEF的最常见、最便宜、可靠和无创的方式。在实践中，心脏病专家持续使用2D US图像来提供LVEF的视觉估计，其基于通过检查在舒张期和收缩期之间LV血池中的面积变化而嵌入在US图像中的2D信息。有一些轶事证据表明，基于LV血池面积变化的LVEF视觉估计显著低估了真实LVEF。真实LVEF应根据舒张期和收缩期之间LV容积的变化计算。在这个项目中，我们利用两个理想化的模型的LV几何形状-一个截断的长椭球体（TPS）和抛物面模型-来代表LV解剖结构。计算使用两种模型模拟的LV形状的横截面积和体积，以比较LVEF。此外，采用LV重建算法从多平面2D US成像数据构建收缩期和舒张期的LV血池体积。我们的数学模型得出基于面积的LVEF为41 ± 4.7%，基于体积的LVEF为55 ± 5.7%，而3D重建模型显示基于面积的LVEF为35 ± 11.9%，基于体积的LVEF为48.0 ± 14.0%。总之，使用所有三种模型的基于面积的LVEF将使用相应模型的基于体积的LVEF低估了13%至14%。该初步研究从数学和经验上证实，基于面积的LVEF估计值确实低估了基于体积的LVEF测量值，并表明必须计算LV血池的真实体积测量值，以正确评估心脏LVEF。
Left ventricular ejection fraction (LVEF) is a critical measure of cardiac health commonly acquired in clinical practice, which serves as the basis for cardiovascular therapeutic treatment. Ultrasound (US) imaging of the heart is the most common, least expensive, reliable and non-invasive modality to assess LVEF. Cardiologists, in practice, persistently use 2D US images to provide visual estimates of LVEF, which are based on 2D information embedded in the US images by examining the area changes in LV blood pool between diastole and systole. There has been some anecdotal evidence that visual estimation of the LVEF based on the area changes of the LV blood pool significantly underestimate true LVEF. True LVEF should be calculated based on changes in LV volumes between diastole and systole. In this project, we utilized both idealized models of the LV geometry - a truncated prolate spheroid (TPS) and a paraboloid model - to represent the LV anatomy. Cross-sectional areas and volumes of simulated LV shapes using both models were calculated to compare the LVEF. Further, a LV reconstruction algorithm was employed to build the LV blood pool volume in both systole and diastole from multi-plane 2D US imaging data. Our mathematical models yielded an area-based LVEF of 41 ± 4.7% and a volume-based LVEF of 55 ± 5.7%, while the 3D reconstruction model showed an area-based LVEF of 35 ± 11.9% and a volume-based LVEF of 48.0 ± 14.0%. In summary, the area-based LVEF using all three models underestimate the volume-based LVEF using corresponding models by 13% to 14%. This preliminary study confirms both mathematically and empirically that area-based LVEF estimates indeed underestimate the true volume-based LVEF measurements and suggests that true volumetric measurements of the LV blood pool must be computed to correctly assess cardiac LVEF.