The authors thank the echocardiographic study subject for volunteering in the video as well as Witten/Herdecke University and HELIOS Research Center (HRC-ID 000416 assigned to Kai O. Hensel) for funding.

プロトコルのコンテンツは、倫理的にウィッテン/ヘルデッケ大学倫理委員会によって承認されています。 1.技術要件<ol><li>十分なセクター・アレイ組織ハーモニックイメージングトランスデューサーを搭載したスペックルトラッキング技術を搭載した心エコー検査装置を利用しています。 </li><li>画像収集、記録との間に電気機械活動に心エコー動画像を同期させるために、心エコー検査デバイスに直接、標準的な3-リードEKGを接続します。これは、その後の後処理の分析の際にタイミング目的のために必須です。 EKGに研究対象を接続し、EKG信号の検出を開始するために超音波画像をフリーズ解除。 </li><li>レコードデジタル以下に詳細に説明されるようにループ（2.1-2.5ステップ）と、外部ディスク上にDICOM形式の動画などのデータを格納します。続いて、オフラインのワークステーションにファイルを転送します。 </li><li>概説したように実行する後処理は、適切なソフトウェアを用いて分析し以下に詳細に（3.1から3.13ステップ）。 </li></ol>心エコーデジタルループの2録音<ol><li> （頭の上に伸ばし、左腕と左サイドに横たわる患者）左側臥位で患者を調べます。 注：プロトコルのこの部分が存在することが、患者/調査対象を必要とします。 </li><li>このような自転車エルゴメータなどのストレスエコー検査様式とSTEを組み合わせるときあるいは、患者は45度直立位置にあることを確認してください。この場合、以前に11を説明したように、標準的な自転車エルゴメータ運動負荷試験法の装置を利用し、標準的なストレス心エコー検査・テストを実行します。心エコー画像の記録時に、肺組織を妨害することによってアーチファクトを最小にするために左側臥身体位置を達成するためのエルゴメータを傾けます。 </li><li>心筋の変形の正確な評価を保証するために、画像の品質を最適化するために特別な注意を払ってください。これを行うには、6との間のフレームレートを調整します「フレームレートを調整」オプションを使用して、毎秒0と80フレーム。さらに、心臓サイクル全体を通して分析されなければならない心筋の構造のすべての側面を含めるように注意を払います。 </li><li>心血管イメージングと心エコー検査12のアメリカの社会の欧州連合によって記載されているように、標準的な心尖部の長軸と胸骨傍短軸面に断面2次元のグレースケールのBモード画像を得ます。レコード複数の連続心臓サイクル（実際には一方のみが必要であり、少なくとも三つの心周期の記録が続く後処理中最高の画質のいずれかを選択できるようにするために推奨される）は、次の面のそれぞれには： <ol><li>以前に12を説明したように、長手方向εとSRの評価のために、標準の頂端4-、3-、および2室ビューをキャプチャします。これを行うには、頂端インパルス（通常はBに近い中心部の頂点に変換器を配置etween 3 番目と5 番目の肋間空間と半ば鎖骨と前方腋窩線との間）。右肩の方に向け、目に見えるようになる関心のあるすべての解剖学的構造までトランスデューサを角張ります。 </li><li>胸骨傍短軸のレコード画像は他で詳細12で説明したように、乳頭筋と頂点が円周εとSRと同様に、半径εとSRを検出するために、僧帽弁のレベルで表示します。あなたはLVの断面垂直なビューを取得するまで、これを行うには、第2または第3肋間と角張るで左胸骨傍の境界にプローブを配置します。 </li></ol></li><li> （ステップ2.2参照）、このような自転車エルゴメータ運動負荷試験法または一連の測定を必要とする任意の他の機能試験法として心臓負荷試験でSTEを組み合わせる場合、各所望の時点で、ステップ2.4を繰り返します。 </li></ol> 3.後処理解析注意：プロトコルのこの部分は、記録された心エコー画像の評価と解釈を含んでいます。それが存在する患者を必要とせず、手順の前の部分に続く任意の時点で行うことができます。 <ol><li>定量的な心エコー検査解析ソフトウェアを利用して、「ファイル」と「開く」をクリックし、目的の心エコー研究データを選びました。患者/スタディを選択し、分析しなければならない心エコー平面を選択します。 </li><li>選択した画像の右下隅に「Q&#39;-アイコンをクリックします。次に、左側の「aCMQ」ボタンを押してください。 </li><li>画面の下部にある緑色の「QRS」スキップキーを使用して、最高の画質の心臓周期を選択しました。ループを再生し、一時停止するには、キーボードのスペースバーを使用します。 </li><li>画面の左側に心エコー図を確認することにより、分析される関心領域（ROI）を選択します。次に、ソフトウェアは自動的にTIを検出してい拡張末期の明とROIを示唆しています。 注：最初のスペックルトラッキング解析は、その後、ソフトウェアによって計算されています。セグメント別およびグローバルε曲線は、画面の下部に表示されます。 </li><li>分節とグローバルSRを視覚化するグラフの下「ひずみ速度」をクリックしてください。 </li><li>視覚的にソフトウェアによって提案されたトラッキング品質を検証。 注：これを行うには、批判的に分析しようとする心筋のすべての側面を完全に心周期全体の間、ROIによって覆われているかどうかを制御します。 ROIに非心筋組織を取り巻く含めないでください。 </li><li>必要な場合は、手動でROI全体またはそれの単一の側面を再配置する、あるいは正確な測定を保証するために（3.8から3.9を参照）を完全にROIを再描画します。 注：必要に応じて、心筋の適切な位置及び幅にROIカバレッジを調整するために透明にROIを設定します。 </li><li>頂端4-、3-、および2室ビューで、ソフトウェアを持っています自動的に7セグメントに心筋を分割することが可能ROIを決定します。 <ol><li>基礎infero中隔/基礎から始まるAVバルブとLV壁の対向する二つの挿入ポイント：ケースROIの再定義が必要であるには、左側に「引く」と3つの基準点で心内膜の境界線をタグ付けから始める]をクリックします頂点の中心と仕上げバルブのinfero-横/基底劣る部分。追跡-心内膜の両方のエンドポイントが完全に弁膜組織を除いた同じレベルであることを確認してください。 </li><li>再配置が必要な場合は、ROIの位置と幅を最適化するために、画面の左側にある[編集]をクリックします。カーソルで個別に各セグメントのマージンだけでなく、心内膜および心外膜の境界線を移動します。その全体にROIを移動する際にナビゲーション/オリエンテーションのための頂点の方を向いて直交ラインを利用しています。 </li><li>最後に、押して、スペックル追跡の再分析を開始画面左側の「計算」ボタンをクリックします。 注：ソフトウェアが自動的に心筋の収縮と弛緩を通してその動きの心筋線維組織に対応する心筋の超微細をそらす「音響マーカー」を、検出します。これらの音響マーカーは、完全な心臓サイクルの全期間を通じてトレースされます。必要な計算は、数秒から数分かかる場合があります。 εとSRは、ソフトウェアによって計算され、数値やグラフィック方法で提示されています。 </li></ol></li><li>の中に 胸骨傍のビューは、ソフトウェアが自動的にあらかじめ定義されたROIを示唆しています。 6つのセグメントに心筋を分割し、手動でこのROIを調整します。 注：ROIの幅は、正確に心筋の厚さと一致する必要があります。 3.8.2で説明したように必要な場合には、ROIの位置と幅を最適化します。でROIを移動する場合、ROIの中心にある点は、ナビゲーション/配向のために利用することができますその全体。 <ol><li>次に、画面の左側にある「計算」ボタンを押すことで、スペックルトラッキング再分析を開始します。 </li></ol></li><li>分節とグローバルεとSRカーブや総合的なブルズアイ形式で表示することを選択しました。これを行うには、画面の左下隅にある「設定」ボタンをクリックします。波形および表示オプションの異なるタイプは、このメニューで選択することができます。 </li><li> ROIの手動再配置が適切な全体的なスペックル追跡品質を達成するのに十分でない場合には、3.1からやり直すとROIを再定義するか、前に次のステップに進むに異なる心周期を選択することを検討してください。 </li><li>その後の統計分析のためのデータを保存してエクスポートします。必要であれば、シネは、ループや静止フレームは、イラストとしてエクスポートすることができます。これを行うには、画面の左下隅に「エクスポート」をクリックし、目的の形式とファイルのディレクトリを選択します。 </li></ol>

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The authors have nothing to disclose.

代替方法に関する技術の意義 LV収縮機能の心エコー評価のための現在のゴールドスタンダードは、LV駆出率（EF）13です。しかし、EFの決意は密接心筋収縮の半径方向成分に相関しているが、考慮重要な長手方向及び周面を取らない単純なアプローチに基づいています。したがって、EFは、心筋の変形の3次元的な複雑さを単純化しすぎ。その結果、EF?...

心血管医学の科学的および臨床シナリオは、より多くのではなく単純なよりも、連続変数とカットオフ値で処理された「yesまたはno &quot;のアルゴリズムです。イメージング技術は、これまで詳細を増やすに心臓機能を評価することができるように進化してきました。スペックル追跡心エコー（STE）は、心筋性能の定量的評価のための新たな診断ツールです。従来の心エコー検査は主観的な読影と、個々の審査官の専門性に強く依存によって制限されているが、STEは、世界と地域の収縮期および拡張期機能1,2を定量化するための再現性と、より客観的な方法として導入されました。 左心室（LV）心筋の変形 - 縦方向および円周方向の短縮だけでなく、拡張期における収縮期およびその逆ラジアル肥厚 - パラメータの歪みを測定する記述することができる（ε）とストラ率の（SR）。 εは、心筋の長さで無次元パーセント変化です。 SRは、ε3の時間導関数です。心筋機能のこれらの重要な指標は、心筋虚血4を識別心臓再同期療法5に対する応答を予測し、従来の心エコーパラメータがまだ6正常のままで無症候性の心筋機能不全を検出することができることが示されています。系統的なメタアナリシスでは、グローバルな長手方向のεは、最も頻繁に使用される定量的なLV収縮機能パラメータは、主要有害心イベントの予測次に、LV駆出率（EF）、現在のゴールドスタンダードのために優れた予後値を有することが示されていますLV収縮機能7の評価。このような短期間の効果などであっても非常に微妙な変化は、無症候性患者における心筋力学上の代謝の変化は、STE 8を利用して検出することができます。 技術的には、STEの使用標準的な心エコー検査・ビューに記録されたグレースケール2Dまたは3D Bモード動画像は、S。いくつかの連続心臓サイクルは、長手方向の変形を測定し、円周方向及び半径方向の変形9用の傍胸骨短軸像にするために、頂端4-、3-および2室ビューに記録されています。また、僧帽弁のレベルでの短軸像を撮影し、乳頭筋と頂点は、LVねじれは、3を評価することができます。その後、デジタル・ループのような画像取得と記憶を、心筋の変形をオフラインのワークステーションまたは超音波装置自体で測定されます。ソフトウェアは、記録されたグレースケール画像でユニークな心筋の画素パターンを検出する、いわゆる「小斑点」と分析心臓サイクル全体を通じて、それらをトレースします。ベクターは、測定された変形パラメータがその後計算されます。このように地域的・世界的な心筋変形が左と右心室のANの両方の収縮期および拡張期に評価することができますDアトリウム10。

<table><tbody><tr><td>Phillips iE33 ultrasound system</td><td>Philips Healthcare</td><td></td><td>http://www.umiultrasound.com/ultrasound-machine/philips/ie33</td></tr><tr><td>S5-1 broadband sector array transducer&amp;nbsp;</td><td>Philips Healthcare</td><td></td><td>5-1 MHz, http://www.usa.philips.com/healthcare/product/HC989605412081/s5-1</td></tr><tr><td>QLAB Advanced Quantification Software Version 10.5</td><td>Philips Healthcare</td><td></td><td>Q-App: Automated Cardiac Motion Quantification (aCMQ), www.philips.com/QLAB-cardiology</td></tr><tr><td>Xcelera R3.3L1 (Version 3.3.1.1103)&amp;nbsp;</td><td>Philips Healthcare</td><td></td><td>http://www.usa.philips.com/healthcare/product/HC830038/xcelera-r41-cardiology-information-management-system</td></tr></tbody></table>

transthoracic speckle tracking echocardiography for the quantitative assessment of left ventricular myocardial deformation

従来の心エコー検査の値は、個体間の画像の解釈の違いや審査官の専門していますので大きく依存によって制限されます。スペックル追跡心エコー（STE）が定量的に地域及び世界の収縮期および拡張期の心筋の性能を評価するために使用できる有望が、技術的に困難な方法です。 、ラジアル周、縦 - - 心筋の変形の心筋歪みと歪み率は、すべての3次元で測定することができます。標準断面の二次元のBモード画像を記録し、続いて心筋内のスペックルの自動化連続的なフレーム単位の追跡および動き分析によって後処理されます。画像はデジタルループとして記録され、タイミングの目的のために3リードEKGに同期されます。長手方向の変形は、頂端4-、3-、2-室ビューで評価されます。円周方向及び半径方向の変形をparasternaで測定されていますリットル、短軸面。 最適な画像品質及び正確な組織の追跡は、心筋性能パラメータの正確な決意のために最も重要です。健常者における経胸壁STEを利用して、本記事では、基本的な手順および定量的な心エコー、心筋変形解析の潜在的な落とし穴の詳細な概要です。

心筋性能の定量的評価のための原則のパラメータは、εおよびSRです。技術的に、全ての心臓チャンバがSTEを用いて分析することができます。スペックル追跡方法は、主にLVを研究するために使用されているので、この記事の焦点は、LV心筋の力学にあります。一般に、長手方向のε及びSRは、最も一般的に評価さLV変形パラメータです。縦εとSRは、心筋の収縮期短縮（?...

Watch this Scientific Journal Video about Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation at JoVE.com

Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation

スペックル追跡心エコー検査は、世界と地域の心筋性能の定量的評価のための新たな画像診断法です。標準ビュー心エコー動画像が記録され、変形パラメータは、その後、心筋のBモード画像内のスペックルの自動化連続的なフレーム単位の追跡および動き分析によって測定されます。

左心室心筋変形の定量的評価のための経胸壁スペックル追跡心エコー検査

The value of conventional echocardiography is limited by differences in inter-individual image interpretation and therefore largely dependent on the ...

transthoracic-speckle-tracking-echocardiography-for-quantitative

Universidad de Cartagena UDEC

Research

JoVE Journal

Medicine

19.4K ビュー.  Witten/Herdecke University. スペックル追跡心エコー検査は、世界と地域の心筋性能の定量的評価のための新たな画像診断法です。標準ビュー心エコー動画像が記録され、変形パラメータは、その後、心筋のBモード画像内のスペックルの自動化連続的なフレーム単位の追跡および動き分析によって測定されます。 

ビデオ: Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation

Transthoracic Echocardiography in Mice

In recent years, murine models have become the primary avenue for studying the molecular mechanisms of cardiac dysfunction resulting from changes in gene expression. Transgenic and gene targeting methods can be used to generate mice with altered cardiac size and function,1-3 and as a result, in vivo techniques are needed to evaluate their cardiac phenotype. Transthoracic echocardiography, pulse wave Doppler (PWD), and tissue Doppler imaging (TDI) can be used to provide dimensional measurements of the mouse heart and to quantify the degree of cardiac systolic and diastolic performance. Two-dimensional imaging is used to detect abnormal anatomy or movements of the left ventricle, whereas M-mode echo is used for quantification of cardiac dimensions and contractility.4,5 In addition, PWD is used to quantify localized velocity of turbulent flow,6 whereas TDI is used to measure the velocity of myocardial motion.7 Thus, transthoracic echocardiography offers a comprehensive method for the noninvasive evaluation of cardiac function in mice.

Transthoracic echocardiography offers a noninvasive method for the evaluation of cardiac function in mice. A combination of ultrasound and Doppler imaging modalities can be used to obtain dimensional measurements of the heart and intracardiac blood flow, which together provide an assessment of cardiac systolic and diastolic performance.

マウスにおける経胸壁心エコー

In recent years, murine models have become the primary avenue for studying the molecular mechanisms of cardiac dysfunction resulting from changes in gene ...

医学

High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart

Ischemia-reperfusion (IR) was surgically performed in murine hearts which were then subjected to repeated imaging to monitor temporal changes in functional parameters of key clinical significance. Two-dimensional movies were acquired at high frame rate (8 kHz) and were utilized to estimate high-quality myocardial strain. Two-dimensional elastograms (strain images), as well as strain profiles, were visualized. Results were powerful in quantitatively assessing IR-induced changes in cardiac events including left-ventricular (LV) contraction, LV relaxation and isovolumetric phases of both pre-IR and post-IR beating hearts in intact mice. In addition, compromised sector-wise wall motion and anatomical deformation in the infarcted myocardium were visualized.  The elastograms were uniquely able to provide information on the following parameters in addition to standard physiological indices that are known to be affected by myocardial infarction in the mouse: internal diameters of mitral valve orifice and aorta, effective regurgitant orifice, myocardial strain (circumferential as well as radial), turbulence in blood flow pattern as revealed by the color Doppler movies and velocity profiles, asynchrony in LV sector, and changes in the length and direction of vectors demonstrating slower and asymmetrical wall movement. This work emphasizes on the visual demonstration of how such analyses are performed. 

High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart 

High frequency Doppler ultrasound is a novel technology for assessing regional myocardial function. This work presents first evidence demonstrating applicability of this versatile imaging platform for the repeated measure of myocardial strain, dp/dt, and mitral regurgitation in the ischemia-reperfused (IR) murine heart.

高周波高分解能心エコー検査：虚血 - 再灌流マウス心臓における心筋ストレイン、収縮性、および僧帽弁閉鎖不全の非侵襲的な反復測定に関する最初の証拠

Ischemia-reperfusion (IR) was surgically performed in murine hearts which were then subjected to repeated imaging to monitor temporal changes in ...

Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking 

Purpose: An accurate and practical method to measure parameters like strain in myocardial tissue is of great clinical value, since it has been shown, that strain is a more sensitive and earlier marker for contractile dysfunction than the frequently used parameter EF. Current technologies for CMR are time consuming and difficult to implement in clinical practice. Feature tracking is a technology that can lead to more automization and robustness of quantitative analysis of medical images with less time consumption than comparable methods.
Methods: An automatic or manual input in a single phase serves as an initialization from which the system starts to track the displacement of individual patterns representing anatomical structures over time. The specialty of this method is that the images do not need to be manipulated in any way beforehand like e.g. tagging of CMR images.
Results: The method is very well suited for tracking muscular tissue and with this allowing quantitative elaboration of myocardium and also blood flow.
Conclusions: This new method offers a robust and time saving procedure to quantify myocardial tissue and blood with displacement, velocity and deformation parameters on regular sequences of CMR imaging. It therefore can be implemented in clinical practice.

Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking

An accurate and practical method to measure parameters like strain in myocardial tissue is of great clinical value, since it has been shown, that strain is a more sensitive and earlier marker for contractile dysfunction than the frequently used parameter EF.

特徴追跡を用いた磁気共鳴が派生心筋ストレインの評価

Purpose: An accurate and practical method to measure parameters like strain in myocardial tissue is of great clinical value, since it has been shown, that ...

Ultrasonic Assessment of Myocardial Microstructure

Echocardiography is a widely accessible imaging modality that is commonly used to noninvasively characterize and quantify changes in cardiac structure and function. Ultrasonic assessments of cardiac tissue can include analyses of backscatter signal intensity within a given region of interest. Previously established techniques have relied predominantly on the integrated or mean value of backscatter signal intensities, which may be susceptible to variability from aliased data from low frame rates and time delays for algorithms based on cyclic variation. Herein, we describe an ultrasound-based imaging algorithm that extends from previous methods, can be applied to a single image frame&#160;and accounts for the full distribution of signal intensity values derived from a given myocardial sample. When applied to representative mouse and human imaging data, the algorithm distinguishes between subjects with and without exposure to chronic afterload resistance. The algorithm offers an enhanced surrogate measure of myocardial microstructure and can be performed using open-access image analysis software.

Echocardiography is commonly used to noninvasively characterize and quantify changes in cardiac structure and function. We describe an ultrasound-based imaging algorithm that offers an enhanced surrogate measure of myocardial microstructure and can be performed using open-access image analysis software.

心筋微細構造の超音波評価

Echocardiography is a widely accessible imaging modality that is commonly used to noninvasively characterize and quantify changes in cardiac structure and ...

Displacement Analysis of Myocardial Mechanical Deformation (DIAMOND) Reveals Segmental Heterogeneity of Cardiac Function in Embryonic Zebrafish

Zebrafish are increasingly utilized as a model organism for cardiomyopathies and regeneration. Current methods evaluating cardiac function fail to reliably detect segmental mechanics and are not readily feasible in zebrafish. Here we present a semiautomated, open-source method for the quantitative assessment of four-dimensional (4D) segmental cardiac function: displacement analysis of myocardial mechanical deformation (DIAMOND). Transgenic embryonic zebrafish were imaged in vivo using a light-sheet fluorescence microscopy system with 4D cardiac motion synchronization. Acquired 3D digital hearts were reconstructed at end-systole and end-diastole, and the ventricle was manually segmented into binary datasets. Then, the heart was reoriented and isotropically resampled along the true short axis, and the ventricle was evenly divided into eight portions (I&#8211;VIII) along the short axis. Due to the different resampling planes and matrices at end-systole and end-diastole, a transformation matrix was applied for image registration to restore the original spatial relationship between the resampled systolic and diastolic image matrices. After image registration, the displacement vector of each segment from end-systole to end-diastole was calculated based on the displacement of mass centroids in three dimensions (3D). DIAMOND shows that basal myocardial segments adjacent to the atrioventricular canal undergo the highest mechanical deformation and are the most susceptible to doxorubicin-induced cardiac injury. Overall, DIAMOND provides novel insights into segmental cardiac mechanics in zebrafish embryos beyond traditional ejection fraction (EF) under both physiological and pathological conditions.

Displacement Analysis of Myocardial Mechanical Deformation DIAMOND Reveals Segmental Heterogeneity of Cardiac Function in Embryonic Zebrafish

The goal of this protocol is to detail a novel method for the assessment of segmental cardiac function in embryonic zebrafish under both physiological and pathological conditions.

心筋機械変形(DIAMOND)の変位解析は、胚性ゼブラフィッシュにおける心機能のセグメント的不均一性を明らかにする

Zebrafish are increasingly utilized as a model organism for cardiomyopathies and regeneration. Current methods evaluating cardiac function fail to ...

発生生物学

Echocardiographic Approaches and Protocols for Comprehensive Phenotypic Characterization of Valvular Heart Disease in Mice

The aim of this manuscript and accompanying video is to provide an overview of the methods and approaches used for imaging heart valve function in rodents, with detailed descriptions of the appropriate methods for anesthesia, the echocardiographic windows used, the imaging planes and probe orientations for image acquisition, the methods for data analysis, and the limitations of emerging technologies for the evaluation of cardiac and valvular function. Importantly, we also highlight several future areas of research in cardiac and heart valve imaging that may be leveraged to gain insights into the pathogenesis of valve disease in preclinical animal models. We propose that using a systematic approach to evaluating cardiac and heart valve function in mice can result in more robust and reproducible data, as well as facilitate the discovery of previously underappreciated phenotypes in genetically-altered and/or physiologically-stressed mice.

This protocol provides a detailed description of the echocardiographic approach for comprehensive phenotyping of heart and heart valve function in mice.

マウスの弁膜症の包括的表現型の特徴のための心エコーアプローチとプロトコル

The aim of this manuscript and accompanying video is to provide an overview of the methods and approaches used for imaging heart valve function in ...

Evaluation of Left Ventricular Structure and Function using 3D Echocardiography

Three-dimensional (3D) quantification of the left ventricle (LV) provides significant added value in terms of diagnostic accuracy and precise risk stratification in various cardiac disorders. Recently, 3D echocardiography became available in routine cardiology practice; however, high-quality image acquisition and subsequent analysis have a steep learning curve. The present article aims to guide the reader through a detailed 3D protocol by presenting tips and tricks and also by highlighting the potential pitfalls to facilitate the widespread but technically sound use of this important technique concerning the LV. First and foremost, we show the acquisition of a high-quality 3D dataset with optimal spatial and temporal resolution. Then, we present the analytical steps toward a detailed quantification of the LV by using one of the most widely applied built-in software. We will quantify LV volumes, sphericity, mass and also systolic function by measuring ejection fraction and myocardial deformation (longitudinal and circumferential strain). We will discuss and provide clinical examples about the essential scenarios where the transition from a conventional echocardiographic approach to a 3D-based quantification is highly recommended.

In this article, we provide a step-by-step acquisition and analysis protocol for the volumetric assessment and speckle-tracking analysis of the left ventricle by 3D echocardiography, particularly focusing on practical aspects that maximize the feasibility of this technique.

3D心エコーを用いた左心室構造と機能の評価

Three-dimensional (3D) quantification of the left ventricle (LV) provides significant added value in terms of diagnostic accuracy and precise risk ...

生物工学

Quantification of Mouse Heart Left Ventricular Function, Myocardial Strain, and Hemodynamic Forces by Cardiovascular Magnetic Resonance Imaging

Mouse models have contributed significantly to understanding genetic and physiological factors involved in healthy cardiac function, how perturbations result in pathology, and how myocardial diseases may be treated. Cardiovascular magnetic resonance imaging (CMR) has become an indispensable tool for a comprehensive in vivo assessment of cardiac anatomy and function. This protocol shows detailed measurements of mouse heart left ventricular function, myocardial strain, and hemodynamic forces using 7-Tesla CMR. First, animal preparation and positioning in the scanner are demonstrated. Survey scans are performed for planning imaging slices in various short- and long-axis views. A series of prospective ECG-triggered short-axis (SA) movies (or CINE images) are acquired covering the heart from apex to base, capturing end-systolic and end-diastolic phases. Subsequently, single-slice, retrospectively gated CINE images are acquired in a midventricular SA view, and in 2-, 3-, and 4-chamber views, to be reconstructed into high-temporal resolution CINE images using custom-built and open-source software. CINE images are subsequently analyzed using dedicated CMR image analysis software.
Delineating endomyocardial and epicardial borders in SA end-systolic and end-diastolic CINE images allows for the calculation of end-systolic and end-diastolic volumes, ejection fraction, and cardiac output. The midventricular SA CINE images are delineated for all cardiac time frames to extract a detailed volume-time curve. Its time derivative allows for the calculation of the diastolic function as the ratio of the early filling and atrial contraction waves. Finally, left ventricular endocardial walls in the 2-, 3-, and 4-chamber views are delineated using feature-tracking, from which longitudinal myocardial strain parameters and left ventricular hemodynamic forces are calculated. In conclusion, this protocol provides detailed in vivo quantification of the mouse cardiac parameters, which can be used to study temporal alterations in cardiac function in various mouse models of heart disease.

This study describes a comprehensive cardiovascular magnetic resonance imaging (CMR) protocol to quantify the left ventricular functional parameters of the mouse heart. The protocol describes the acquisition, post-processing, and analysis of the CMR images as well as assessment of different cardiac functional parameters.

心臓血管磁気共鳴画像法によるマウス心左心室機能、心筋緊張、血行力の定量化

Mouse models have contributed significantly to understanding genetic and physiological factors involved in healthy cardiac function, how perturbations ...

Transthoracic Echocardiographic Examination in the Rabbit Model

Large animal models such as the rabbit are valuable for translational preclinical research. Rabbits have a similar cardiac electrophysiology compared to that of humans and that of other large animal models such as dogs and pigs. However, the rabbit model has the additional advantage of lower maintenance costs compared to other large animal models. The longitudinal evaluation of cardiac function using echocardiography, when appropriately implemented, is a useful methodology for preclinical assessment of novel therapies for heart failure with reduced ejection fraction (e.g. cardiac regeneration). The correct use of this non-invasive tool requires the implementation of a standardized examination protocol following international guidelines. Here we describe, step by step, a detailed protocol supervised by veterinary cardiologists for performing echocardiography in the rabbit model, and demonstrate how to correctly obtain the different echocardiographic views and imaging planes, as well as the different imaging modes available in a clinical echocardiography system routinely used in human and veterinary patients.

Here we describe, step by step, a detailed protocol for performing echocardiography in the rabbit model. We show how to correctly obtain the different echocardiographic views and imaging planes, as well as the different imaging modes available in a clinical echocardiography system routinely used in human and veterinary patients.

ウサギモデルにおける経胸部心エコー検査

Large animal models such as the rabbit are valuable for translational preclinical research. Rabbits have a similar cardiac electrophysiology compared to ...

Revealing Subtle Changes in Cardiac Function using Transthoracic Dobutamine Stress Echocardiography in Mice

Left ventricular (LV) dysfunction paves the final pathway for a multitude of cardiac disorders. With the non-invasive high-frequency transthoracic dobutamine stress echocardiography in humans, a reductionist investigation approach to unmask subtle changes in cardiac function has become possible. Here, we provide a protocol for using this technique in mice to facilitate expanded analysis of LV architecture and function in physiology and pathology enabling the observation of alterations in models of cardiac disease hidden in unstressed hearts. This investigation can be performed in one and the same animal and allows both, basal and pharmacologically stress-induced measurements. We outline detailed criteria for appropriate anesthesia, imaging-based LV analysis, consideration of intra- and interobserver variability, and obtaining positive inotrope response that can be attained in mice after intraperitoneal injection of dobutamine under near physiological conditions. To recapitulate the characteristics of human physiology and disease in small animal models, we highlight critical pitfalls in evaluation, e.g., a pronounced Bowditch effect in mice. To further meet translational objectives, we compare stress-induced effects in humans and mice. When used in translational studies, attention must be paid to physiological differences between mice and human. Experimental rigor dictates that some parameters assessed in patients can only be used with caution due to restrictions in spatial and temporal resolution in mouse models.

Left ventricular dysfunction constitutes the final common pathway for a host of cardiac disorders. We here provide a detailed protocol of transthoracic dobutamine stress echocardiography approach for comprehensive evaluation of the left ventricular function of mouse models of cardiac disease as well as cardiac phenotyping.