Name: quantification of global diastolic function by kinematic modeling-based analysis of transmitral flow via the parametrized diastolic filling formalism
Uploaded: 2014-09-01T14:00:00
Description: Watch this Scientific Journal Video about Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism at JoVE.

Dette arbejde blev støttet delvist af Alan A. og Edith L. Wolff Charitable Trust, St. Louis, og Barnes-Jewish Hospital Foundation. L. Shmuylovich og E. Ghosh blev delvist støttet af predoctoral stipendier fra Heartland Affiliate af American Heart Association. S. Zhu fik delvis støtte fra Washington University Compton Lærde Program og College of Arts og Sciences &#39;Sommer Undergraduate Research Award. S. Mossahebi fik delvis støtte fra Institut for Fysik.

Proceduren for at erhverve ekkokardiografiske billeder og analysere dem for at opnå de PDF-parametre beskrevet nedenfor. Selvom hjertekateterisation er nævnt i emnet udvælgelse del nedenfor, er metoden kun gælder for ekkokardiografisk del. Beskrivelsen af kateterisation del blev medtaget for uafhængig validering af model baserede forudsigelser og er relateret til analyse af E-bølger via PDF-formalisme. Forud for dataopsamling, giver alle fag underskrevet, informeret samtykke til at deltage i undersøgelse...

<ol>
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I overensstemmelse med vores methodologic fokus, er de vigtigste aspekter af de metoder, der fremmer opnår nøjagtige og meningsfulde resultater fremhævet. Ekkokardiografi American Society of Ekkokardiografi (ASE) har retningslinjer for udførelsen af transthoracic undersøgelser 16. Under et ekko eksamen, er der et væld af faktorer, der påvirker billedkvaliteten. Faktorer, der er uden for kontrol af sonographer nævnes: tekniske egenskaber imager ...

Banebrydende studier af Katz 1 i 1930 viste, at pattedyrs venstre ventrikel initierer fyldning ved at være en mekanisk sugepumpe, og en stor indsats siden da har været afsat til at udrede arbejdet i diastole. For mange år, invasive metoder var de eneste muligheder for kliniske eller forskning vurdering af diastolisk funktion (DF) 2-16. I 1970&#39;erne imidlertid tekniske fremskridt og udviklingen i ekkokardiografi endelig gav kardiologer og fysiologer praktiske værktøjer til invasiv karakterisering af DF. Uden en samlende kausal teori eller paradigme for diastole om, hvordan hjertet fungerer, når det fylder, foreslog forskerne talrige phenomenologic indekser baseret på korrelation med kliniske funktioner. Den krum, hastigt stigende og faldende form transmitral blodgennemstrømning hastighed konturen under tidlig, hurtig fyldning, for eksempel, blev tilnærmet som en trekant og diastolisk function indekser blev defineret fra geometriske træk (højde, bredde, areal, etc..) i denne trekant. Tekniske fremskridt i ekkokardiografi har tilladt væv bevægelse, stamme, og stamme sats under påfyldning der skal måles, for eksempel, og hver teknisk fremskridt bragte med sig en ny afgrøde af fænomenologiske indekser at være korreleret med kliniske funktioner. Men indekser forblive korrelative og ikke kausale og mange indekser er forskellige mål for den samme underliggende fysiologi. Det er derfor ikke overraskende, at øjeblikket er beskæftiget kliniske indekser for DF har begrænset specificitet og sensitivitet. For at overvinde disse begrænsninger den parametriserede diastolisk fyldning (PDF) formalisme, en kausal kinematiske blev slået parameter model af venstre ventrikel fyldning, der er motiveret af og inkorporerer suge-pumpe fysiologi diastole udviklet og valideret 17. It-modeller diastolisk funktion (som manifesteret ved de krumme formeraf transmitral flow konturer) i overensstemmelse med reglerne i dæmpet harmonisk oscillerende bevægelse. Ligningen for dæmpet harmonisk oscillerende bevægelse er baseret på Newtons anden lov og kan skrives, pr masseenhed, som: <img alt="Ligning 1" fo:content-width="1in" src="/files/ftp_upload/51471/51471eq1.jpg" /> Ligning 1 Denne lineære 2. orden differentialligning har tre parametre: K - kammer stivhed c - viskoelasticitet / afslapning, og x O - oscillator oprindelige forskydning / forspænding. Modellen forudsiger, at de forskellige klinisk observerede diastolisk påfyldning mønstre er resultatet af variationen i den numeriske værdi af disse tre modelparametre. Baseret på PDF-formalisme og klassisk mekanik, kan e-bølger klassificeres som værende bestemt af under-dæmpede, eller over-dæmpet regimer bevægelse. Talrige undersøgelser <sup&gt; 17-21 har valideret, at klinisk indspillet E-bølge konturer og PDF model forudsagde konturer viser fremragende aftale, og har belyst de hæmodynamiske / fysiologiske analoger af de tre PDF-parametre 21. Processen for at udvinde modelparametre fra klinisk indspillet E-bølge data er detaljeret beskrevet i nedenstående metoder. I modsætning til typiske indekser for DF i nuværende klinisk brug, PDF modellens tre parametre er årsagssammenhæng baseret på. Som omtalt i nedenstående metoder kan yderligere indekser diastolisk fysiologi udledes disse grundlæggende parametre, og ved anvendelsen af ​​PDF formalisme aspekter af diastole andet end transmitral flow. I dette arbejde, metoder til PDF-baseret analyse af transmitral flow og de fysiologiske relationer, der kan drages fra PDF tilgang, dens parametre og de afledte indekser er beskrevet. Derudover er det vist, at de PDF-parametre eller indekser er afledt af dem kan drillehinanden iboende egenskaber kammeret de eksterne virkninger af belastning kan give korrelater til traditionelle invasivt definerede parametre og kan skelne mellem normale og patologiske grupper.

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			<td height="42" style="height:42px;width:216px;">Name of Equipment/ Software</td>
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			<td height="21" style="height:21px;width:216px;">Philips iE33</td>
			<td style="width:159px;">Philips (Andover, MA.)</td>
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			<td height="21" style="height:21px;width:216px;">LabVIEW 6.0</td>
			<td style="width:159px;">National Instruments</td>
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			<td>Version 6.0.2</td>
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			<td height="21" style="height:21px;width:216px;">MATLAB</td>
			<td style="width:159px;">MathWorks</td>
			<td style="width:119px;"></td>
			<td>Version R2010b</td>
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quantification of global diastolic function by kinematic modeling-based analysis of transmitral flow via the parametrized diastolic filling formalism

Kvantitativ hjertefunktion vurdering fortsat en udfordring for fysiologer og klinikere. Selvom historisk invasive metoder har omfattet det eneste tilgængelige middel, udvikling af ikke-invasive billeddiagnostiske metoder (ekkokardiografi, MRI, CT) med høj tidslig og rumlig opløsning giver et nyt vindue til kvantitativ diastolisk funktion vurdering. Ekkokardiografi er den aftalte standard for diastolisk funktion vurdering, men indekser i den aktuelle klinisk brug blot Udnyt udvalgte funktioner i kammerets dimension (M-mode) eller blod / væv bevægelse (Doppler) bølgeformer uden at inkorporere de fysiologiske kausale determinanter for bevægelsen selv. Erkendelsen af, at alle venstre ventrikler (LV) Påbegynde påfyldning ved at tjene som mekaniske sugepumper tillader globale diastolisk funktion, der skal vurderes på baggrund af love om bevægelse, der gælder for alle kamre. Hvad adskiller et hjerte fra en anden er de parametre af ligningen af ​​bevægelse, natioErns påfyldning. Følgelig udvikling af parametriserede diastolisk Påfyldning (PDF) formalisme har vist, at hele spektret af klinisk observerede tidligt transmitral flow (Doppler E-bølge) mønstre er særdeles godt fit af lovene i dæmpede svingninger. Dette tillader analyse af individuelle e-bølger i overensstemmelse med en kausal mekanisme (rekyl-initieret sugning), der giver tre (numerisk) unikke klumpet parametre, hvis fysiologisk analoger er kammer stivhed (k), viskoelasticitet / afslapning (C), og belastning (x o). Optagelsen af ​​transmitral flow (Doppler E-bølger) er almindelig praksis i klinisk kardiologi og derfor ekkokardiografiske optagelse metode er kun kortvarigt revideret. Vores fokus er på bestemmelse af PDF-parametre fra rutinemæssigt optaget E-wave-data. Da de fremhævede resultater indikerer, når PDF-parametre er blevet indhentet fra et passende antal belastning varierende E-bølgerne, undersøforskers er gratis at bruge parametre eller konstruere indekser fra parametrene (såsom oplagret energi 1/2 kx O 2, maksimal AV trykgradient kx o, belastning uafhængig indeks for diastolisk funktion, mv.), og vælg det aspekt af fysiologi eller patofysiologi skal kvantificeres.

Doppler bølgeformer repræsenterer de fire forskellige typer af påfyldningsmaskiner mønstre (normal, pseudonormal, forsinket afslapning, konstriktiv-begrænsende) under anvendelse af fremgangsmåden beskrevet ovenfor er vist i figur 2. Figur 2A viser det normale mønster, som i sig selv ikke kan skelnes fra den pseudonormal mønster. Figur 2B viser en forsinket afslapning og figur 2C viser et snærende-restriktiv mønster forbundet med alvorlig diastolisk dysfunktion...

Watch this Scientific Journal Video about Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism at JoVE.

Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism

Kvantificering af Global diastolisk funktion ved Kinematisk Modeling-baseret analyse af Transmitral Flow via parametriserede diastolisk Filling Formalisme

Præcis, kausalitet-baserede kvantificering af den globale diastolisk funktion er opnået ved kinematisk modellering-baseret analyse af transmitral strøm via parametriserede diastolisk fyldning (PDF) formalisme. PDF skaber unikke stivhed, afslapning og Indlæsningsparametre og belyser &quot;nye&quot; fysiologi samtidig give følsomme og specifikke indeks på dysfunktion.

Quantitative cardiac function assessment remains a challenge for physiologists and clinicians.&#160;Although historically invasive methods have comprised ...

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