Automatic echocardiographic measurements detect left ventricular dysfunction

Jahn Frederik Noraas Grue has evaluated automatic measurements of mitral annular motion indices with color tissue Doppler apical four-chamber echocardiography.


MAIN RESULTS:

  1. Automatic measurements of systolic mitral annular motion indices can help detect left ventricular dysfunction.
  2. Normal ranges for automatic tissue Doppler measurements have been established.
  3. Dedicated operator education and training is necessary even with automatic echocardiographic measurements.

THESIS DEFENCE:

Thesis: Automatic measurements of mitral annular motion indices
Candidate: Jahn Frederik Noraas Grue
Time: April 1, 2020 at 12:15
Place: Online-based solution, due to the covid-19 situation
Link to university website (in Norwegian)


SUMMARY:

(1) Automatic measurements of mitral annular plane systolic excursions (MAPSE) of at least 10 mm detected left ventricular dysfunction with 82 % specificity and 76 % sensitivity. The automatic measurements agreed better with expert echocardiographic evaluation than student recordings. The study includes color tissue Doppler apical four-chamber recordings of 221 patients, among whom 49 had systolic and 11 had diastolic dysfunction. Medical students examined 20 of the patients.

(2) Based on echocardiography of 1157 healthy men and women, Grue and colleagues have established age- and sex-specific reference ranges for automatic MAPSE measurements of left ventricular function, as well as mitral annular peak velocities in systole (S′) and early (e′) and late (a′) diastole. Echocardiographic assessments were performed during the third wave of the Nord-Trøndelag Health Study in 2006-2008. The automatic measurements were in line with the manual measurements.

(3) Appropriate education of operators is important before automatic measurements could be implemented in the clinic. Experienced clinicians obtained manual measurements of MAPSE, S’ and e’ from 75 patients. Thereafter, a medical student with only 15 minutes explanation on how to aquire an apical four-chamber view performed the same measurements. When correctly tracked, the agreement between student and clinician recordings was good. However, the mitral annulus could only be tracked correctly in 67 % of the students’ recordings, compared to 84 % of the clinicians’ and. Image quality was also higher in the clinicians’ recordings.


REFERENCES:

(1) Grue, J. F., Storve, S., Dalen, H., Salvesen, Ø., Mjølstad, O. C., Samstad, S. O., Torp, H., & Haugen, B. O. (2018). Automatic measurements of mitral annular plane systolic excursion and velocities to detect left ventricular dysfunctionUltrasound in medicine & biology44(1), 168-176.

(2) Grue, J. F., Storve, S., Støylen, A., Torp, H., Haugen, B. O., Mølmen, H. E., & Dalen, H. (2019). Normal ranges for automatic measurements of tissue Doppler indices of mitral annular motion by echocardiography. Data from the HUNT3 Study. Echocardiography36(9), 1646-1655.

(3) Grue, J. F., Storve, S., Dalen, H., Mjølstad, O. C., Samstad, S. O., Eriksen-Volnes, T., Torp, H., & Haugen, B. O. (2020). Automatic quantification of left ventricular function by medical students using ultrasoundBMC Medical Imaging20(1), 1-8.

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