Author + information
- Received May 5, 2016
- Revision received September 28, 2016
- Accepted October 3, 2016
- Published online November 6, 2017.
- Alaa Mabrouk Salem Omar, MD, PhDa,b,
- Sukrit Narula, BAa,
- Mohamed Ahmed Abdel Rahman, MDc,
- Gianni Pedrizzetti, PhDd,
- Hala Raslan, MDb,
- Osama Rifaie, MDc,
- Jagat Narula, MD, PhDa and
- Partho P. Sengupta, MD, DMa,∗ ()
- aDepartment of Cardiology, Icahn School of Medicine at Mount Sinai University, New York, New York
- bDepartment of Internal Medicine, Medical Division, National Research Centre, Cairo, Egypt
- cDepartment of Cardiology, Ain Shams University, Cairo, Egypt
- dDepartment Engineering and Architecture, University of Trieste, Trieste, Italy
- ↵∗Address for correspondence:
Dr. Partho P. Sengupta, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, One Gustave L. Levy Place, P.O. Box 1030, New York, New York 10029.
Objectives The aim of this study was to investigate whether cluster analysis of left atrial and left ventricular (LV) mechanical deformation parameters provide sufficient information for Doppler-independent assessment of LV diastolic function.
Background Medical imaging produces substantial phenotyping data, and superior computational analyses could allow automated classification of repetitive patterns into patient groups with similar behavior.
Methods The authors performed a cluster analysis and developed a model of LV diastolic function from an initial exploratory cohort of 130 patients that was subsequently tested in a prospective cohort of 44 patients undergoing cardiac catheterization. Patients in both study groups had standard echocardiographic examination with Doppler-derived assessment of diastolic function. Both the left ventricle and the left atrium were tracked simultaneously using speckle-tracking echocardiography (STE) for measuring simultaneous changes in left atrial and ventricular volumes, volume rates, longitudinal strains, and strain rates. Patients in the validation group also underwent invasive measurements of pulmonary capillary wedge pressure and LV end diastolic pressure immediately after echocardiography. The similarity between STE and conventional 2-dimensional and Doppler methods of diastolic function was investigated in both the exploratory and validation cohorts.
Results STE demonstrated strong correlations with the conventional indices and independently clustered the patients into 3 groups with conventional measurements verifying increasing severity of diastolic dysfunction and LV filling pressures. A multivariable linear regression model also allowed estimation of E/e′ and pulmonary capillary wedge pressure by STE in the validation cohort.
Conclusions Tracking deformation of the left-sided cardiac chambers from routine cardiac ultrasound images provides accurate information for Doppler-independent phenotypic characterization of LV diastolic function and noninvasive assessment of LV filling pressures.
- big-data analytics
- diastolic dysfunction
- left ventricular filling pressures
- speckle-tracking echocardiography
Dr. Pedrizzetti is in a research partnership with Tomtec. Dr. Jagat Narula has received research support as an equipment grant to his institution from Panasonic, Philips, and GE Healthcare; and has received minimal honorarium from GE Healthcare. Dr. Sengupta has served as an advisor to Heart Test Laboratory and Tele Health Robotics; as a consultant for Hitachi-Aloka; and has received research grants from Forest Laboratories and Heart Test Laboratory. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
A. Jamil Tajik, MD, served as the Guest Editor for this paper.
- Received May 5, 2016.
- Revision received September 28, 2016.
- Accepted October 3, 2016.
- 2017 American College of Cardiology Foundation