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Clinical Implications of Transitioning from 2D to Fully Automated 3D Echocardiography

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (10 August 2023) | Viewed by 6657

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Special Issue Editors

Dr. Mauro Pepi

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Guest Editor

Centro Cardiologico Monzino, IRCCS, Milan, Italy
Interests: cardiac imaging; valve disease; 3D echocardiography; pericardial disease
Special Issues, Collections and Topics in MDPI journals

Dr. Andrea Barbieri

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Guest Editor

Department of Cardiology, Policlinico Hospital, Modena and Reggio Emilia University, Modena, Italy
Interests: echocardiography; cardiac function; left ventricular hypertrophy; valvular heart disease; acute heart failure

Special Issue Information

Dear Colleagues

It is well known that the demand for routine reporting of echocardiographic three-dimensional (3D) chamber quantifications and function is growing because of expanding indications. Competing against this need are other pressures that affect echocardiography laboratory time and resources. Presently, the continued developments in artificial, anatomically intelligent 3D with minimal user interaction allow larger data sets to be obtained that include multi-chamber or whole-heart imaging. Automation’s potential benefits include time and cost savings associated with streamlining image acquisition, rapid analysis and reporting, and greater accuracy and reproducibility of measurements. As a result, automation of 3D measurements can significantly alter the workflow in echocardiography laboratories. However, some issues still need to be overcome considering that the reference values for cardiac chamber volumes measured with 3D and two-dimensional echocardiography (2DE) are significantly different and cannot be used interchangeably. Additionally, different companies have developed their own algorithms to post-process data sets and measure cardiac structures’ geometry and function.

Therefore, we are publishing this Special Issue in the Journal of Clinical Medicine to facilitate fully automated 3D measurement adoption in the modern-day echo laboratory, primarily focusing on quantitation of the left or right ventricular and atrial chamber volumes and on geometry function. Topics of interest include but are not limited to the following:

Assessment of consistency of chamber measurements by 2DE and 3DE;
Establishment of 3DE reference values and outcome data;
Cost-effective studies justifying 3DE’s co-existence with conventional 2DE;
3DE border sensitivity settings;
Standardized protocols when incorporating 3DE.

Of particular interest are papers which attempt to integrate 3DE above traditional 2DE methods and their clinical implications. We look forward to your contributions.

Dr. Mauro Pepi
Dr. Andrea Barbieri
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

artificial intelligence
automation
machine learning
three-dimensional echocardiography
cardiac chamber quantification

Published Papers (4 papers)

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Editorial

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5 pages, 204 KiB

Open AccessEditorial

Three-Dimensional Echocardiography Based on Automation and Machine Learning Principles and the Renaissance of Cardiac Morphometry

by Andrea Barbieri and Mauro Pepi

J. Clin. Med. 2022, 11(15), 4357; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11154357 - 27 Jul 2022

Cited by 2 | Viewed by 1278

Abstract

Today, the core component of all transthoracic echocardiography reports is the quantification of cardiac chamber size and function using advanced echocardiography modalities such as three-dimensional echocardiography (3DE), in line with the rising demand for quantifications of cardiac chambers with high measurement accuracy and [...] Read more.

(This article belongs to the Special Issue Clinical Implications of Transitioning from 2D to Fully Automated 3D Echocardiography)

Research

Jump to: Editorial

10 pages, 1939 KiB

Open AccessArticle

Dependence of Left Ventricular Rotational Mechanics on Left Atrial Volumes in Non-Smoker Healthy Adults: Analysis Based on the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Healthy Study

by Attila Nemes, Árpád Kormányos, Zoltán Ruzsa, Alexandru Achim, Nóra Ambrus and Csaba Lengyel

J. Clin. Med. 2023, 12(3), 1235; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12031235 - 03 Feb 2023

Cited by 5 | Viewed by 1214

Abstract

Introduction: As has been established, the left ventricle (LV) and the left atrium (LA) form an organic unit of the left heart; however, little is known about the dependence of LV rotational parameters on LA volumes, even in healthy circumstances. Therefore, the present study aimed to assess the associations between basal and apical LV rotations and LA volumes and volume-based functional properties throughout the cardiac cycle in healthy adults by three-dimensional speckle-tracking echocardiography. Methods: The present study comprised 167 healthy adults (age: 33.4 ± 12.6 years, 77 males) with normally directed LV rotational mechanics. All subjects underwent complete two-dimensional Doppler echocardiography with three-dimensional speckle-tracking echocardiography (3DSTE)-derived data acquisition. The 3DSTE-derived LA volumes and LV rotational parameters were determined at a later date. Results: An increasing end-systolic maximum LA volume (Vmax) was associated with increasing pre-atrial-contraction early (VpreA) and minimum end-diastolic (Vmin) LA volumes, and all stroke volumes were increased as well. Systolic basal left ventricular rotation (LVrot) was highest in the case of the highest systolic Vmax and early-diastolic VpreA. Apical LVrot did not show obvious associations with any increasing LA volumes. The highest systolic basal LVrot was associated with significantly increased diastolic VpreA and Vmin. Reduced diastolic LA volumes (VpreA, Vmin) were seen in the case of increased apical LVrot. An increasing basal LVrot was associated with the tendentious lowering of the apical LVrot and the significant elevation of LV twist. Similarly, an increasing apical LVrot was associated with the tendentious lowering of basal LVrot and the significant elevation of LV twist. Conclusions: Strong associations and adaptations between 3DSTE-derived LA volumes throughout the cardiac cycle and LV rotational mechanics were evidenced, even in healthy circumstances. Full article

(This article belongs to the Special Issue Clinical Implications of Transitioning from 2D to Fully Automated 3D Echocardiography)

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13 pages, 2801 KiB

Open AccessArticle

Three-Dimensional Automated, Machine-Learning-Based Left Heart Chamber Metrics: Associations with Prevalent Vascular Risk Factors and Cardiovascular Diseases

by Andrea Barbieri, Alessandro Albini, Simona Chiusolo, Nicola Forzati, Vera Laus, Anna Maisano, Federico Muto, Matteo Passiatore, Marco Stuani, Laura Torlai Triglia, Marco Vitolo, Valentina Ziveri and Giuseppe Boriani

J. Clin. Med. 2022, 11(24), 7363; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11247363 - 12 Dec 2022

Cited by 3 | Viewed by 1564

Abstract

Background. Three-dimensional transthoracic echocardiography (3DE) powered by artificial intelligence provides accurate left chamber quantification in good accordance with cardiac magnetic resonance and has the potential to revolutionize our clinical practice. Aims. To evaluate the association and the independent value of dynamic heart model (DHM)-derived left atrial (LA) and left ventricular (LV) metrics with prevalent vascular risk factors (VRFs) and cardiovascular diseases (CVDs) in a large, unselected population. Materials and Methods. We estimated the association of DHM metrics with VRFs (hypertension, diabetes) and CVDs (atrial fibrillation, stroke, ischemic heart disease, cardiomyopathies, >moderate valvular heart disease/prosthesis), stratified by prevalent disease status: participants without VRFs or CVDs (healthy), with at least one VRFs but without CVDs, and with at least one CVDs. Results. We retrospectively included 1069 subjects (median age 62 [IQR 49–74]; 50.6% women). When comparing VRFs with the healthy, significant difference in maximum and minimum indexed atrial volume (LAVi max and LAVi min), left atrial ejection fraction (LAEF), left ventricular mass/left ventricular end-diastolic volume ratio, and left ventricular global function index (LVGFI) were recorded (p < 0.05). In the adjusted logistic regression, LAVi min, LAEF, LV ejection fraction, and LVGFI showed the most robust association (OR 3.03 [95% CI 2.48–3.70], 0.45 [95% CI 0.39–0.51], 0.28 [95% CI 0.22–0.35], and 0.22 [95% CI 0.16–0.28], respectively, with CVDs. Conclusions. The present data suggested that novel 3DE left heart chamber metrics by DHM such as LAEF, LAVi min, and LVGFI can refine our echocardiographic disease discrimination capacity. Full article

(This article belongs to the Special Issue Clinical Implications of Transitioning from 2D to Fully Automated 3D Echocardiography)

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15 pages, 1907 KiB

Open AccessArticle

Utility of Real-Time Three-Dimensional Echocardiography for the Assessment of Right Ventricular Morphology and Function in Large Animal Models

by Yunosuke Yuchi, Ryohei Suzuki, Riho Higuchi, Takahiro Saito, Takahiro Teshima, Hirotaka Matsumoto and Hidekazu Koyama

J. Clin. Med. 2022, 11(7), 2001; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11072001 - 02 Apr 2022

Cited by 4 | Viewed by 1769

Abstract

Real-time three-dimensional echocardiography (RT3DE) enables a noninvasive assessment of right ventricular (RV) morphology. However, no study has evaluated the relationship between RV function obtained by RT3DE and RV pressure-volume loops. This hypothesis-driven, experimental study aimed to assess the utility of RT3DE in the evaluation of RV morphology and function. Ten anesthetized beagle dogs sequentially underwent dobutamine infusion, acute infusion of lactated Ringer’s solution, and furosemide administration to alter RV contractility and loading conditions. RV pressure-volume loop-derived hemodynamic measurements and echocardiography, including two-dimensional speckle-tracking echocardiography and RT3DE, were performed in each study protocol. Bland–Altman analysis showed strong agreement in RV volume, ejection fraction, and stroke volume obtained by right heart catheterization and RT3DE. Multiple regression analyses revealed that the peak myocardial velocity of the lateral tricuspid annulus (RV s’) and global RV longitudinal strain rate were significantly associated with end-systolic elastance (adjusted r² = 0.66, p < 0.001). RV s’, RV free wall longitudinal strain, and RT3DE-derived stroke volume/end-systolic RV volume ratio were associated with RV pressure-volume loops-derived end-systolic/arterial elastance ratio (adjusted r² = 0.34, p < 0.001). RT3DE could detect the changes in catheterization-derived RV volume with a strong agreement and might be useful in estimating RV-pulmonary arterial coupling. Full article

(This article belongs to the Special Issue Clinical Implications of Transitioning from 2D to Fully Automated 3D Echocardiography)

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