Session S21.2

Novel Time-Varying 3D Display of Wall Motion, Strain, Strain Rate and Torsion for LV Function Assessment

NL Greenberg*, ZB Popovic, G Saracino, RA Grimm, JD Thomas

The Cleveland Clinic
Cleveland, OH, USA

Background: Standard acquisition of echocardiographic data (i.e. 3 parallel short-axis views and 3 rotational long axis views) results in a total of 72 time-varying traces of segmental linear strains and 18 traces of segmental rotational data. If one separates the signal from endo, mid, and epicardial myocardial layers, this results in a staggering 246 time-varying traces. The synthesis of this amount of data is extremely difficult. Our goal was to develop tools that can visualize this complex dataset in a single representation and use this tool to assess LV function in groups of subjects to examine characteristic patterns.
Methods: The first step of the algorithm was to develop a bull’s eye plot diagram showing the distribution of strain in a single time point (e.g. end-systole). Strain magnitude is represented by a color scale. Strain values in the middle of each segment are equivalent to the actual segmental value obtained by the trace while other values are interpolated. Since there are 3 strain components, 3 bull’s eye plots are shown side-by-side for a direct comparison of concordance. The second step in development was an extension to show the time-varying changes in a dynamic display that demonstrates the evolution of strain. To evaluate this algorithm and approach, we compared standard reading of echocardiography data with this novel approach to assess the time saved/lost with, as well as to assess whether this implementation changes the final report in terms of LV segmental function, viability/fibrosis detection, LV dyssynchrony, etc. We believe that this approach assists with the visual determination of dyssynchrony/scar and the the area of dyssynchrony. We also believe that this approach is applicable to stress testing in ischemic heart disease and cardiac resynchronization therapy. Further development of a four-dimensional representation wire-frame mesh that contains both circumferential and longitudinal elements is being explored where wire-frame coordinates would be based on actual x, y, z coordinates obtained from the speckle tracking data. Regional “bricks” would be constructed and temporal deformation would be imposed using three components of linear strain and rotational data.

(Abstract Control Number: 252)