Intrinsic Cardiovascular Wave and Strain Imaging
Cardiovascular diseases remain America’s primary killer by a large margin, claiming the lives of more Americans than the next two main causes of death combined (cancer and pulmonary complications). In particular, coronary artery disease (CAD) is by far th
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Abstract Cardiovascular diseases remain America’s primary killer by a large margin, claiming the lives of more Americans than the next two main causes of death combined (cancer and pulmonary complications). In particular, coronary artery disease (CAD) is by far the most lethal, causing 17% of all (cardiac-related or not) deaths every year. One of the main reasons for this high death toll is the severe lack of effective and accessible imaging tools upon anomaly detected on the electrocardiogram (ECG), especially at the early stages when CAD can be stabilized with appropriate pharmacological regimen. Arrhythmias refer to the disruption of the natural heart rhythm. Cardiac arrhythmias lead to a significant number of cardiovascular morbidity and mortality. This irregular heart rhythm causes the heart to suddenly stop pumping blood. Atrial pathologies are the most common arrhythmias with atrial fibrillation and atrial flutter being the most prevalent. In this chapter, we introduce ultrasound-based methodologies that are based on inferring to the mechanical and electrical properties of the myocardium in order to better image the onset and progression of the aforementioned diseases.
1 Myocardial Elastography 1.1 Introduction According to the latest report on Heart Disease and Stroke Statistics by the American Heart Association [6], more than 2150 Americans die of cardiovascular disease each day, an average of 1 death every 40 s. Cardiovascular disease currently claims more lives each year in both men and women than the next two most deadly diseases combined, i.e., cancer and chronic lower respiratory disease. Among the cardiovascular diseases, coronary artery disease (CAD) is by far the most deadly causing approximately 1 of every 6 deaths in the United States in 2010. Approximately every 34 s, E. Konofagou (B) Columbia University, 1210 Amsterdam Ave, ET351, MC 8904, New York, NY 10027, USA e-mail: [email protected] © Springer Nature Singapore Pte Ltd. 2019 S. Golemati and K. S. Nikita (eds.), Cardiovascular Computing—Methodologies and Clinical Applications, Series in BioEngineering, https://doi.org/10.1007/978-981-10-5092-3_8
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experienced exponential growth in new procedures, the progress in the development of novel diagnostic techniques has stalled by comparison.
1.2 Mechanical Deformation of Normal and Ischemic or Infarcted Myocardium Detection of cardiac dysfunction through assessment of the mechanical properties of the heart, and more specifically, the left-ventricular muscle, has been a long-term goal in diagnostic cardiology. This is because both ischemia [8], i.e., the reduced oxygenation of the muscle necessary for its contraction, and infarction [2], i.e., the complete loss of blood supply inducing myocyte death, alter the mechanical properties and contractility of the myocardium. In the ischemic heart, the diastolic left-ventricular pressure-volume or pressure-length curve slope is typically increased, suggesting increased chamber stiffness. Regional myocardial stiffness has also be
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