Reading workstation for clinical contrast echocardiography

项目摘要 冠状动脉微血管功能障碍（MVD）作为冠状动脉粥样硬化的病理生理学的一部分越来越受到重视。 许多疾病，包括MINOCA（非阻塞性冠状动脉心肌梗死），心脏 移植物血管病变和射血分数保留的心力衰竭（HFpEF）。冠状动脉MVD发生 更常见于女性，尽管存在心肌缺血， 冠状动脉造影正常或接近正常。确定患者中的MVD仍然具有挑战性， 延迟或漏诊，即使这些情况下的心血管事件发生率与那些 患有冠状动脉疾病因此，需要临床工具来快速准确地检测 了以下条件超声造影对心肌微循环的显像研究 被称为心肌造影超声心动图（MCE）的药物，有数十年的数据表明， MCE在评估MVD患者中的诊断和预后益处。在许多方面，MCE是首选 灌注评估的方法，因为它更方便，更便宜，更可用， 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的临床使用仅限于该领域的少数专家，这在很大程度上是由于 MCE解释的感知经验依赖。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。在经证实的超声心动图检查与 技术和必要的技术，以有效、用户友好和标准化的方法应用MCE。 Narnar LLC正在开发一种用户友好的对比超声心动图定量和可视化软件。 该产品旨在通过快速判读来克服MCE现有的关键限制。 这种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 用超声心动图检测MVD第二阶段提案的总体目标是将原型产品化 将软件集成到一个全面的软件解决方案中， 现有的技术（超声，FDA批准的增强剂）将使心脏病专家能够自信地 通过对比超声心动图评估功能和灌注。

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.