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Biomedical Imaging Technologies for Cardiovascular Disease

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A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Biosciences and Bioengineering".

Deadline for manuscript submissions: closed (20 March 2022) | Viewed by 20172

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Special Issue Editor

Dr. Julio Garcia Flores

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Guest Editor

1. Department of Cardiac Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
2. Department of Radiology, University of Calgary, Calgary, AB T2N 1N4, Canada
3. Stephenson Cardiac Imaging Centre, University of Calgary, Calgary, AB T2N 1N4, Canada
4. Libin Cardiovascular Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
5. Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
Interests: cardiac imaging; flow hemodynamics; experimental models; cardiac magnetic resonance; cardiovascular 4-dimensional flow (4D Flow) imaging
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Dear Colleagues,

Biomedical imaging technologies have substantially increased in number and diversity over the past several years. An important improvement in accuracy, sensitivity, and refinement has been possible thanks to technological advances in software and hardware. In particular, cardiovascular disease assessment of anatomy, hemodynamics, and tissue biomarkers saw exceptional improvement, aiding the stratification of patient risk and therapy. The recent integration of artificial intelligence and machine learning have also supported novel approaches for personalized image-based diagnosis. In addition, image-based computational-assisted diagnosis is a promising option for uncovering key insights into disease progression and personalized solutions.

This Special Issue is dedicated to collecting the most recent progress in biomedical imaging technologies for cardiovascular disease. The Issue will cover a wide range of topics, including but not limited to:

Advances in cardiac echo-cardiography;
Advances in cardiac computed tomography;
Advances in cardiac magnetic resonance;
Advances in positron emission tomography;
Advances in cardiovascular image processing;
Advances in image-guided interventions;
Advances in personalized cardiac imaging;
Advances in the integration of medical imaging and computational modelling;
Advanced in biomedical imaging using machine learning and artificial intelligence;
Advances in experimental cardiac imaging.

We look forward to receiving your contributions.

Dr. Julio Garcia Flores
Guest Editor

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Related Special Issues

Biomedical Imaging Technologies for Cardiovascular Disease - Volume II in Applied Sciences (18 articles)
Biomedical Imaging Technologies for Cardiovascular Disease—3rd Edition in Applied Sciences (2 articles)

Published Papers (11 papers)

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Editorial

Jump to: Research, Review

4 pages, 192 KiB

Open AccessEditorial

Biomedical Imaging Technologies for Cardiovascular Disease

by Julio Garcia

Appl. Sci. 2023, 13(4), 2209; https://doi.org/10.3390/app13042209 - 9 Feb 2023

Viewed by 910

Abstract

Non-invasive biomedical imaging technologies for investigating the heart’s physiology, performance, function, and structure have increased in number and diversity over the past several years [...] Full article

(This article belongs to the Special Issue Biomedical Imaging Technologies for Cardiovascular Disease)

Research

Jump to: Editorial, Review

10 pages, 1384 KiB

Open AccessArticle

Effects of Cardiac Contractility Modulation Therapy on Right Ventricular Function: An Echocardiographic Study

by Carla Contaldi, Stefano De Vivo, Maria L. Martucci, Antonio D’Onofrio, Ernesto Ammendola, Gerardo Nigro, Vittoria Errigo, Giuseppe Pacileo and Daniele Masarone

Appl. Sci. 2022, 12(15), 7917; https://doi.org/10.3390/app12157917 - 7 Aug 2022

Cited by 8 | Viewed by 2559

Abstract

Background. Cardiac contractility modulation (CCM) is a novel device-based therapy for patients with heart failure with reduced and mild reduced ejection fraction (HFrEF/HFmrEF). CCM increases cardiac performance and produces reverse left ventricular remodeling, with improved symptoms, functional capacity, quality of life, and reduced HF-related hospitalizations. However, to date, little evidence is available on the effects of CCM on right ventricle (RV) function. Therefore, we analyzed the effects of CCM on RV systolic function and RV–pulmonary artery (PA) coupling. Methods. Twenty-one (65 ± 12.5 years) patients with NYHA class III, ejection fraction < 40% and QRS < 120 ms were assessed at baseline. During follow up, two patients had died, and so nineteen patients were evaluated six months after CCM therapy. Using echocardiography, tricuspid annular systolic excursion (TAPSE), myocardial systolic excursion velocity (RVs), and RV free-wall strain was measured. PA systolic pressure (PASP) was estimated from tricuspid regurgitation, adding the right atrial pressure estimation. The RV-PA coupling was calculated as TAPSE/PASP ratio. Results. After six months, patients who underwent CCM therapy showed a reduction in RV diameters and improved RV systolic function, as evidenced by the increase in both TAPSE (16.6 ± 4.2 mm vs. 18.5 ± 3.6 mm; p < 0.05), RVs (10.1 ± 1.8 cm/s vs. 11.3 ± 11.4 cm/s; p < 0.05), and RV strain (−13.7 ± 1.8% vs. −15.6 ± 2.3%; p < 0.05). CCM also determined a reduction in PASP (34.2 ± 9.8 mmHg vs. 28 ± 6.2 mmHg; p < 0.05) and an increase in the TAPSE/PASP ratio (0.52 ± 0.14 mm/mmHg vs. 0.66 ± 0.23 mm/mmHg; p < 0.05). Conclusions. At six months, CCM increases RV reverse remodeling and performance, reducing RV size and improving RV systolic function, PASP, and RV-PA coupling. Full article

(This article belongs to the Special Issue Biomedical Imaging Technologies for Cardiovascular Disease)

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9 pages, 709 KiB

Open AccessArticle

New Possibilities in Heart Failure: The Effects of Tadalafil on Diastolic Function in Patients Undergoing Robot-Assisted Radical Prostatectomy

by Felice Crocetto, Vittoria Cuomo, Ciro Santoro, Ludovica Fiorillo, Biagio Barone, Davide Arcaniolo, Teresa Fedele, Ciro Imbimbo and Roberta Esposito

Appl. Sci. 2022, 12(11), 5629; https://doi.org/10.3390/app12115629 - 1 Jun 2022

Cited by 2 | Viewed by 2305

Abstract

Inhibitors of phosphodiesterase type 5 (PDE5i) are the first-line treatment for erectile dysfunction and are also used to treat pulmonary hypertension. PDE5i impedes the breakdown of nitric oxide (NO)-driven cyclic guanosine monophosphate (cGMP) in smooth muscle cells of the vascular bed, acting as a potent vasodilator. In heart failure, cGMP signaling is altered. The modulation of cGMP has therefore emerged as a potential therapeutic option for heart failure. In this prospective observational study, we aim to investigate whether tadalafil, a long-acting PDE5i used for erectile dysfunction, could also improve diastolic function assessed by cardiac ultrasound. A total of 23 patients were enrolled, undergoing nerve-sparing robot-assisted radical prostatectomy for prostate cancer and treated with 20 mg tadalafil on alternate days to recover erectile function. All patients underwent tadalafil treatment for at least 6 months. Participants underwent a clinical and cardiac ultrasound with color Doppler assessment at baseline, after 3 months, and after 6 months. At 6 months, no significant difference was found apart from lower E/e’ ratio (7.4 ± 2.7 vs. 6.3 ± 1.3; p < 0.03), peak velocity of TR jet (2.4 ± 0.2 vs. 2.1 ± 0.2; p < 0.001), and PAPs (27.3 ± 3.6 vs. 22.9 ± 5.7; p < 0.005). Our prospective study shows that 6 months of erectile dysfunction therapy for secondary to radical prostatectomy is associated with a favorable effect on diastolic function, improving the E/e’ ratio and peak velocity of the TR jet. Full article

(This article belongs to the Special Issue Biomedical Imaging Technologies for Cardiovascular Disease)

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13 pages, 2754 KiB

Open AccessArticle

A Novel Speckle-Tracking Echocardiography Derived Parameter That Predicts Clinical Worsening in Children with Pulmonary Arterial Hypertension

by Iolanda Muntean, Mihaela Melinte, Amalia Făgărășan, Carmen Corina Șuteu and Rodica Togănel

Appl. Sci. 2022, 12(11), 5494; https://doi.org/10.3390/app12115494 - 28 May 2022

Cited by 2 | Viewed by 1453

Abstract

Pulmonary arterial hypertension is a severe, progressive disease in children, that causes right ventricular dysfunction over time. Tissue motion annular displacement is a novel speckle-tracking derived echocardiographic parameter used in assessing ventricular function. The aim of our study was to determine the prognostic value of this echocardiographic parameter in children with pulmonary arterial hypertension. We conducted a case-control study by assessing twenty children with pulmonary arterial hypertension (idiopathic or secondary) and twenty age- and sex-matched controls, using clinical (WHO functional class, 6-min walking test), laboratory (brain natriuretic peptide level) and echocardiographic parameters (conventional and speckle-tracking derived tissue motion annular displacement) at enrolment and after one year of follow-up. According to their WHO functional class altering after one year, the pulmonary arterial hypertension patients were divided into two groups: non-worsening (eleven) and worsening (nine). The conventional echocardiographic parameters and all measured tricuspid tissue motion annular displacement indices (lateral, septal, midpoint and midpoint fractional displacement—TMADm%) were significantly lower in both pulmonary arterial hypertension groups (non-worsening and worsening) compared to controls. Comparing the worsening and non-worsening groups, only the TMADm% and brain natriuretic peptide level was significantly lower in worsening in comparison with non-worsening pulmonary arterial hypertension children (p = 0.010 and p = 0.018, respectively). In receiver-operating characteristic curve analysis, we found a cut-off value of 16.15% for TMADm% and a cut-off value of 34.35 pg/mL for the brain natriuretic peptide level that can predict worsening in pulmonary arterial hypertension children. In conclusion, tricuspid annulus midpoint fractional displacement, an angle-dependent speckle-tracking derived parameter, could be a good additional parameter in the assessment of the longitudinal right ventricular systolic function and in prediction of clinical worsening in children with pulmonary arterial hypertension. Full article

(This article belongs to the Special Issue Biomedical Imaging Technologies for Cardiovascular Disease)

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16 pages, 4508 KiB

Open AccessArticle

Automated Classification of Left Ventricular Hypertrophy on Cardiac MRI

by Adam Budai, Ferenc Imre Suhai, Kristof Csorba, Zsofia Dohy, Liliana Szabo, Bela Merkely and Hajnalka Vago

Appl. Sci. 2022, 12(9), 4151; https://doi.org/10.3390/app12094151 - 20 Apr 2022

Cited by 5 | Viewed by 2156

Abstract

Left ventricular hypertrophy is an independent predictor of coronary artery disease, stroke, and heart failure. Our aim was to detect LVH cardiac magnetic resonance (CMR) scans with automatic methods. We developed an ensemble model based on a three-dimensional version of ResNet. The input of the network included short-axis and long-axis images. We also introduced a standardization methodology to unify the input images for noise reduction. The output of the network is the decision whether the patient has hypertrophy or not. We included 428 patients (mean age: 49 ± 18 years, 262 males) with LVH (346 hypertrophic cardiomyopathy, 45 cardiac amyloidosis, 11 Anderson–Fabry disease, 16 endomyocardial fibrosis, 10 aortic stenosis). Our control group consisted of 234 healthy subjects (mean age: 35 ± 15 years; 126 males) without any known cardiovascular diseases. The developed machine-learning-based model achieved a 92% F1-score and 97% recall on the hold-out dataset, which is comparable to the medical experts. Experiments showed that the standardization method was able to significantly boost the performance of the algorithm. The algorithm could improve the diagnostic accuracy, and it could open a new door to AI applications in CMR. Full article

(This article belongs to the Special Issue Biomedical Imaging Technologies for Cardiovascular Disease)

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15 pages, 3245 KiB

Open AccessArticle

4D Flow MRI in Ascending Aortic Aneurysms: Reproducibility of Hemodynamic Parameters

by Joe F. Juffermans, Hans C. van Assen, Bastiaan J. C. te Kiefte, Mitch J. F. G. Ramaekers, Roel L. F. van der Palen, Pieter van den Boogaard, Bouke P. Adriaans, Joachim E. Wildberger, Ilona A. Dekkers, Arthur J. H. A. Scholte, Simon Schalla, Hildo J. Lamb and Jos J. M. Westenberg

Appl. Sci. 2022, 12(8), 3912; https://doi.org/10.3390/app12083912 - 13 Apr 2022

Cited by 1 | Viewed by 1735

Abstract

(1) Background: Aorta hemodynamics have been associated with aortic remodeling, but the reproducibility of its assessment has been evaluated marginally in patients with thoracic aortic aneurysm (TAA). The current study evaluated intra- and interobserver reproducibility of 4D flow MRI-derived hemodynamic parameters (normalized flow displacement, flow jet angle, wall shear stress (WSS) magnitude, axial WSS, circumferential WSS, WSS angle, vorticity, helicity, and local normalized helicity (LNH)) in TAA patients; (2) Methods: The thoracic aorta of 20 patients was semi-automatically segmented on 4D flow MRI data in 5 systolic phases by 3 different observers. Each time-dependent segmentation was manually improved and partitioned into six anatomical segments. The hemodynamic parameters were quantified per phase and segment. The coefficient of variation (COV) and intraclass correlation coefficient (ICC) were calculated; (3) Results: A total of 2400 lumen segments were analyzed. The mean aneurysm diameter was 50.8 ± 2.7 mm. The intra- and interobserver analysis demonstrated a good reproducibility (COV = 16–30% and ICC = 0.84–0.94) for normalized flow displacement and jet angle, a very good-to-excellent reproducibility (COV = 3–26% and ICC = 0.87–1.00) for all WSS components, helicity and LNH, and an excellent reproducibility (COV = 3–10% and ICC = 0.96–1.00) for vorticity; (4) Conclusion: 4D flow MRI-derived hemodynamic parameters are reproducible within the thoracic aorta in TAA patients. Full article

(This article belongs to the Special Issue Biomedical Imaging Technologies for Cardiovascular Disease)

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12 pages, 1199 KiB

Open AccessArticle

Pulmonary Artery Remodeling and Advanced Hemodynamics: Magnetic Resonance Imaging Biomarkers of Pulmonary Hypertension

by Zachary M. Hong and Julio Garcia

Appl. Sci. 2022, 12(7), 3518; https://doi.org/10.3390/app12073518 - 30 Mar 2022

Cited by 4 | Viewed by 1621

Abstract

Poorly characterized by non-invasive diagnostic imaging techniques, pulmonary hypertension (PHT) is commonly associated with changes in vascular hemodynamics and remodeling of pulmonary artery architecture. These disease phenotypes represent potential biomarkers of interest in clinical environment. In this retrospective clinical study, 33 patients with pulmonary hypertension and seventeen controls were recruited. Architectural remodeling was characterized using 3D-contrast enhanced angiogram via the measurement of pulmonary artery diameters, bifurcation distances, and angles. Hemodynamics were characterized using 4D-flow magnetic resonance imaging (MRI) via wall shear stress, kinetic energy, vorticity, and directional flow dynamics. Parameters were compared using independent samples student’s t-tests. Correlational analysis was performed using Pearson’s correlation. PHT patients demonstrated dilation in the main and right branch of the pulmonary artery (p < 0.05). Furthermore, these patients also exhibited increases in bifurcation distances in the left and right pulmonary arteries (p < 0.05). Wall shear stress, maximum kinetic energy, and energy loss were decreased in the pulmonary artery (p < 0.001). Correlations were observed between peak velocities and right ventricle ejection fraction (r = 0.527, p < 0.05). These findings suggest that pulmonary artery remodeling and hemodynamic changes may possess clinical utility as MRI biomarkers for PHT. Full article

(This article belongs to the Special Issue Biomedical Imaging Technologies for Cardiovascular Disease)

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10 pages, 2541 KiB

Open AccessFeature PaperArticle

Impact of Respiratory Gating on Hemodynamic Parameters from 4D Flow MRI

by Esteban Denecken, Julio Sotelo, Cristobal Arrieta, Marcelo E. Andia and Sergio Uribe

Appl. Sci. 2022, 12(6), 2943; https://doi.org/10.3390/app12062943 - 14 Mar 2022

Cited by 2 | Viewed by 1440

Abstract

The hemodynamic parameters from 4D flow datasets have shown promising diagnostic value in different cardiovascular pathologies. However, the behavior of these parameters can be affected when the 4D flow data are corrupted by respiratory motion. The purpose of this work was to perform a quantitative comparison between hemodynamic parameters computed from 4D flow cardiac MRI both with and without respiratory self-gating. We considered 4D flow MRI data from 15 healthy volunteers (10 men and 5 women, 30.40 ± 6.23 years of age) that were acquired at 3T. Using a semiautomatic segmentation process of the aorta, we obtained the hemodynamic parameters from the 4D flow MRI, with and without respiratory self-gating. A statistical analysis, using the Wilcoxon signed-rank test and Bland–Altman, was performed to compare the hemodynamic parameters from both acquisitions. We found that the calculations of the hemodynamic parameters from 4D flow data that were acquired without respiratory self-gating showed underestimated values in the aortic arch, and the descending and diaphragmatic aorta. We also found a significant variability of the hemodynamic parameters in the ascending aorta of healthy volunteers when comparing both methods. The 4D flow MRI requires respiratory compensation to provide reliable calculations of hemodynamic parameters. Full article

(This article belongs to the Special Issue Biomedical Imaging Technologies for Cardiovascular Disease)

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18 pages, 29773 KiB

Open AccessArticle

Comprehensive Assessment of Left Intraventricular Hemodynamics Using a Finite Element Method: An Application to Dilated Cardiomyopathy Patients

by Pamela Franco, Julio Sotelo, Cristian Montalba, Bram Ruijsink, Eric Kerfoot, David Nordsletten, Joaquín Mura, Daniel Hurtado and Sergio Uribe

Appl. Sci. 2021, 11(23), 11165; https://doi.org/10.3390/app112311165 - 25 Nov 2021

Cited by 1 | Viewed by 1861

Abstract

In this paper, we applied a method for quantifying several left intraventricular hemodynamic parameters from 4D Flow data and its application in a proof-of-concept study in dilated cardiomyopathy (DCM) patients. In total, 12 healthy volunteers and 13 DCM patients under treatment underwent short-axis cine b-SSFP and 4D Flow MRI. Following 3D segmentation of the left ventricular (LV) cavity and registration of both sequences, several hemodynamic parameters were calculated at peak systole, e-wave, and end-diastole using a finite element approach. Sensitivity, inter- and intra-observer reproducibility of hemodynamic parameters were evaluated by analyzing LV segmentation. A local analysis was performed by dividing the LV cavity into 16 regions. We found significant differences between volunteers and patients in velocity, vorticity, viscous dissipation, energy loss, and kinetic energy at peak systole and e-wave. Furthermore, although five patients showed a recovered ejection fraction after treatment, their hemodynamic parameters remained low. We obtained several hemodynamic parameters with high inter- and intra-observer reproducibility. The sensitivity study revealed that hemodynamic parameters showed a higher accuracy when the segmentation underestimates the LV volumes. Our approach was able to identify abnormal flow patterns in DCM patients compared to volunteers and can be applied to any other cardiovascular diseases. Full article

(This article belongs to the Special Issue Biomedical Imaging Technologies for Cardiovascular Disease)

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Review

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9 pages, 854 KiB

Open AccessReview

Ultrasmall Superparamagnetic Particles of Iron Oxide and Cardiac Magnetic Resonance: Novel Imaging in Everyday Conditions

by Vasiliki Tsampasian, Ioannis Merinopoulos, Donnie Cameron, Pankaj Garg and Vassilios S. Vassiliou

Appl. Sci. 2022, 12(14), 6913; https://doi.org/10.3390/app12146913 - 8 Jul 2022

Cited by 2 | Viewed by 1382

Abstract

Myocardial inflammation has been hypothesised to be the common underlying mechanism through which several cardiovascular diseases develop and progress. Cardiac magnetic resonance (CMR) has become a powerful non-invasive tool that enables the direct visualisation of the myocardium. The emerging use of ultrasmall superparamagnetic particles of iron oxide (USPIO) and their magnetic properties is gaining a lot of research interest. USPIO-enhanced CMR can provide valuable information, as it allows for the identification of active inflammation in the myocardium, a process that has been hypothesised to be the substrate for adverse remodelling and, eventually, heart failure. In this review, we summarise the properties of USPIO and their role in cardiac magnetic resonance imaging as well as their clinical applications. Full article

(This article belongs to the Special Issue Biomedical Imaging Technologies for Cardiovascular Disease)

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8 pages, 2846 KiB

Open AccessReview

Positron Emission Tomography in Coronary Heart Disease

by José de Almeida, Sofia Martinho, Lino Gonçalves and Maria Ferreira

Appl. Sci. 2022, 12(9), 4704; https://doi.org/10.3390/app12094704 - 7 May 2022

Cited by 3 | Viewed by 1533

Abstract

With advances in scanner technology, postprocessing techniques, and the development of novel positron emission tomography (PET) tracers, the applications of PET for the study of coronary heart disease have been gaining momentum in the last few years. Depending on the tracer and acquisition protocol, cardiac PET can be used to evaluate the atherosclerotic lesion (plaque imaging) and to assess its potential consequences—ischemic versus nonischemic (perfusion imaging) and viable versus scarred (viability imaging) myocardium. The scope of this review is to summarize the role of PET in coronary heart disease. Full article

(This article belongs to the Special Issue Biomedical Imaging Technologies for Cardiovascular Disease)

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