Abstract 19406: Fusion of Coronary Anatomy from Computed Tomography with Left Ventricular Strain Function from 3D Echocardiography
Introduction: Cardiac multimodality imaging offers novel ways to display composite information not available with any of the imaging modalities alone. We tested the feasibility of fusion of coronary anatomy and left ventricular (LV) strain, as index of LV function, obtained from computed tomography (CT) and 3D echocardiography (3DE), respectively.
Methods: We enrolled 17 patients undergoing CT coronary angiography and transthoracic 3DE imaging on the same day. CT images were acquired according to standard clinical protocol at 78% of the cardiac cycle (Philips 256-slice). Apical full-volume 3DE images were acquired (Philips iE33). Images were analyzed off-line using dedicated workstations: CT to isolate the coronary tree (Philips) and 3DE to derive a dynamic LV endocardial surface (TomTec) and maps of 3D longitudinal (LS) and radial (RS) strain. Custom software was used to co-register LV surfaces and CT coronary tree, minimizing the distance between corresponding anatomic landmarks, and to map peak systolic values of LS and RS on the 3D endocardial shells.
Results: Three patients were excluded because of the suboptimal quality of the coronary CT (feasibility 88%). The composite display of coronary arteries and parametric images depicting strain abnormalities yielded an identification of the functional significance of the stenosis when present. While patients with normal coronary arteries had uniform parametric images of wall motion, those with significant stenosis (N=3/17), had wall motion abnormality in the area supplied by the stenosed artery (Figure).
Conclusions: The results of this pilot study indicate that fusion of CT coronary angiography and 3DE derived strain is feasible, potentially providing physiologically meaningful and easy-to-interpret combined display of coronary abnormalities and their functional impact. The proposed approach is versatile, as it allows fusion of coronary anatomy with a variety of parameters of cardiac mechanics.
Author Disclosures: F. Maffessanti: None. V. Mor-Avi: None. K. Addetia: None. G. Murtagh: None. L. Weinert: None. R. Baumann: Employment; Significant; TomTec Imaging Systems, Unterschleissheim, Germany. A.R. patel: Research Grant; Significant; Astellas Pharma. Other Research Support; Significant; Philips Medical System. R.M. Lang: Speakers Bureau; Modest; Philips Medical Systems. Honoraria; Modest; Philips Medical Systems.
- © 2014 by American Heart Association, Inc.