Quantification of Left Ventricular Shape Differentiates Pediatric Pulmonary Hypertension Subjects from Matched Controls

[+] Author and Article Information
Jennifer Wagner

R.T.(R), B.S., University of Colorado Department of Bioengineering, Aurora, Colorado

Bruce F. Landeck II

M.D., University of Colorado School of Medicine, Aurora, Colorado

Kendall Hunter

University of Colorado Department of Bioengineering, Aurora, Colorado

1Corresponding author.

ASME doi:10.1115/1.4038408 History: Received September 25, 2017; Revised November 05, 2017


Background: Changes in left ventricular (LV) shape are observed in patients with pulmonary hypertension (PH). Quantification of ventricular shape could serve as a tool to non-invasively monitor pediatric patients with PH. Decomposing the shape of a ventricle into a series of components and magnitudes will facilitate differentiation of healthy and PH subjects. Methods: Parasternal short axis echo images acquired from 53 pediatric subjects with PH and 53 age and sex-matched normal control subjects underwent speckle tracking using Velocity Vector Imaging (Siemens) to produce a series of x,y coordinates tracing the LV endocardium in each frame. Coordinates were converted to polar format after which the Fourier transform was used to derive shape component magnitudes in each frame. Magnitudes of the first 11 components were normalized to heart size (magnitude/LV length as measured on apical view) and analyzed across a single cardiac cycle. Logistic regression was used to test predictive power of the method. Results: Fourier decomposition produced a series of shape components from short axis echo views of the LV (Figure 1). All 11 components analyzed were significantly different between groups (Figure 2). The accuracy index of the receiver operator curve was 0.85. Conclusion: Quantification of LV shape can differentiate normal pediatric subjects from those with PH. Shape analysis is a promising method to precisely describe shape changes observed in PH. Differences between groups speak to intraventricular coupling that occurs in right ventricular overload. Further analysis investigating the correlation of shape to clinical parameters is underway.

Copyright (c) 2017 by ASME
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