Reading workstation for clinical contrast echocardiography

项目总结 冠状动脉微血管功能障碍(MVD)作为冠状动脉病变病理生理学的一部分日益受到重视。 许多情况包括MINOCA(非梗阻性冠状动脉心肌梗死)，心脏 移植血管病变和心力衰竭保留射血分数(HFpEF)。发生冠状动脉微血管病变 更常见于女性，尽管存在心肌缺血，但仍可导致胸痛 冠状动脉造影正常或接近正常。识别患者的MVD仍然具有挑战性，结果是 延迟或漏诊，即使这些情况下的心血管事件发生率与 有明确的冠状动脉疾病。因此，需要临床工具来快速和准确地检测 这些条件。超声心动图在心肌微循环成像中的应用 被称为心肌声学造影(MCE)的药物有几十年的数据表明 MCE对评估MVD患者的诊断和预后价值。在许多方面，MCE是首选 一种更方便、更便宜、更有效的血流灌注评估方法 核成像(SPECT)、正电子发射断层扫描(PET)和心脏MRI的比较技术。 然而，MCE的临床应用仅限于该领域的少数专家，这在很大程度上是由于 MCE解释的知觉经验依赖性。目前，还没有广泛可用的临床工具来 支持MCE定量分析和解释。经证实的超声心动图在临床上存在差距 技术和以高效、用户友好和标准化的方法应用MCE所需的技术。 Narnar LLC正在开发一种用户友好的声学造影定量和可视化软件。 该产品旨在通过实现快速翻译来克服MCE现有的关键限制。 这一新的临床工具将评估心肌血流-功能关系，这对识别患者至关重要 超声心动图检查MVD。这个第二阶段提案的总体目标是将原型生产出来 软件集成到全面的软件解决方案中，在使用已有的 可用的技术(超声波、FDA批准的增强剂)将使心脏病专家能够自信地 用超声心动图评价心脏功能和血流灌注。

PROJECT SUMMARY Coronary microvascular dysfunction (MVD) is increasingly being appreciated as a part of the pathophysiology of a number of conditions including MINOCA (myocardial infarction with nonobstructive coronary arteries), heart transplant graft vasculopathy, and heart failure with preserved ejection fraction (HFpEF). Coronary MVD occurs more commonly in women and can result in chest pain due to myocardial ischemia despite the presence of normal or near normal coronary angiograms. Identifying MVD in patients remains challenging and results in delayed or missed diagnoses even though cardiovascular event rates in these conditions are similar to those with established coronary artery disease. Clinical tools are therefore needed to both rapidly and accurately detect these conditions. Echocardiographic imaging of the myocardial microcirculation using ultrasound contrast agents, referred to as myocardial contrast echocardiography (MCE), has decades of data demonstrating the diagnostic and prognostic benefit of MCE in evaluating patients with MVD. In many ways, MCE is the preferred method for perfusion assessment because it is more convenient, less expensive, and more available than comparative techniques of nuclear imaging (SPECT), positron emission tomography (PET), and cardiac MRI. However, the clinical use of MCE has been limited to only a handful of experts in the field due in large part to the perceived experience dependence of MCE interpretation. Currently, no widely available clinical tools exist to support MCE quantitative analysis and interpretation. A clinical gap exists between a proven echocardiographic technique and the technology necessary to apply MCE in an efficient, user friendly and standardized method. Narnar LLC is developing a user-friendly contrast echocardiography quantification and visualization software. This product is designed to overcome the existing critical limitations of MCE by enabling rapid interpretation. This new clinical tool will evaluate the myocardial flow-function relationship that is critical to identifying patients with MVD by using echocardiography. The overall aim of this phase II proposal is to productionize the prototype software into a comprehensive software solution that when integrated into the current workflows using already available technologies (ultrasound, FDA approved enhancing agents) will enable a cardiologist to confidently assess both function and perfusion by contrast echocardiography.