Multiparametric Computational Echocardiography

描述(由申请人提供)： 在美国，在500万心脏左心室(LV)机械性衰竭患者中，心肌缺血是近70%的潜在病因。超声心动图(ECHO)非常适合于左心功能的分析，然而，以定量、客观和可重复性的方式传达这一临床重要信息的问题仍然存在。 为了解决这一问题并响应NIH PA-00-117生物医学信息科学和技术创新征集，拟议的R21/R33项目的长期目标是开发方法，用于1)左心功能的定量和客观测量，2)基于这些测量的可重复性诊断解释，以及3)结果的标准化拓扑图和参数显示。定义了LV函数的3个参数：1)局部变形速率(应变率)，2)变形幅度(应变)，3)循环变形过渡(交叉点)的时间间隔。 长期目标的实际执行将通过开发多参数计算回声(MPCE)系统来实现。这个R21/R33项目的主要假设是，MPCE系统将a)精确和准确地定量(R21期)和b)可重复地临床解释(R33期)节段性左心功能。这一假设将在来自动物模型和代表广泛节段性左心室功能障碍的心肌缺血临床病例的数字回波数据上进行验证。 具体目标(R21阶段)： 目标1-开发局部心功能参数分析的算法(1年级)。 目的2-使用MPCE(2年级)测试局部左心室功能分析的精密度和准确性。 满足预定义的里程碑将启动R33阶段。 具体目标(R33阶段)： 目标1-开发一个神经网络MPCE系统，并在动物身上进行初步测试(3岁)。 目标2-改进参数映射并测试人类MPCE数据的重复性(4岁)。 该项目的成功完成将导致对左心功能的无创、定量、客观和可重复性的解释，从而促进心脏病学的最佳诊断和治疗决策。

DESCRIPTION (provided by applicant): In the United States, myocardial ischemia is the underlying etiology in nearly 70% of the 5 million patients suffering from mechanical failure of the cardiac left ventricle (LV). Echocardiography (echo) is well suited for the analysis of LV function, however, the problem of conveying this clinically important information in a quantitative, objective, and reproducible manner persists. To address this problem and respond to the NIH PA-00-117 solicitation for innovations in biomedical information science and technology, the long-term goal of the proposed R21/R33 project is to develop methods for 1) quantitative and objective measurement of LV function, 2) reproducible diagnostic interpretation based on these measurements, and 3) standardized topologic mapping and parametric display of the results. We defined 3 parameters of LV function: 1) rate of local deformation (strain rate), 2) amplitude of deformation (strain), and 3) time interval to the transition (crossover) point of cyclic deformation. The practical implementation of the long-term objectives will be achieved through the development of a Multiparametric Computational Echo (MPCE) system. The main hypothesis of this R21/R33 project is that the MPCE system will a) precisely and accurately quantitate (R21 phase) and b) reproducibly clinically interpret (R33 phase) segmental LV function. This hypothesis will be tested on digital echo data from animal models and clinical cases of myocardial ischemia representing a wide range of segmental LV dysfunction. Specific Aims (R21 phase): Aim 1 - Develop algorithms for parametric analysis of local ventricular function (Year 1). Aim 2 - Test precision and accuracy of local LV functional analysis using MPCE (Year 2). Satisfaction of the predefined milestones will initiate the commencement of the R33 phase. Specific Aims (R33 phase): Aim 1 - Develop a neural network MPCE system and test it initially in animals (Year 3). Aim 2 - Refine parametric mapping and test reproducibility of MPCE data in humans (Year 4). Successful completion of this project will result in noninvasive, quantitative, objective, and reproducible interpretation of LV function, thus facilitating optimal diagnostic and therapeutic decisions in cardiology.