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Tom Claessens

Publications and source records attributed to Tom Claessens.

4 recordsLinked to original sources

Assessment of the tilting properties of the human mitral valve during three main phases of the heart cycle: an echocardiographic study.

RATIONALE AND OBJECTIVES: In experimental models of the left heart, the mitral valve (MV) is commonly implanted perpendicular to a central axis of the apex/MV. To adapt this to a more correct anatomical model, as well as for further studies of the left ventricle, we created a database of implantation angles of the MV and annulus during three main phases of the heart cycle, based on standard cardiac ultrasound measurements. MATERIALS AND METHODS: Twenty-eight patients were studied with the standard cardiac ultrasound equipment. From the apical echo window, an anteroposterior (AP) plane and a perpendicular commisure-commisure (CC) plane were generated during three critical moments in the heart cycle: systole (S); diastole early filling (E); and diastole late filling (A). In both planes, the angles between the annular plane and each mitral leaflet, as well as the angle between a theoretical longitudinal axis through the apex and center of the MV orifice and the mitral annulus plane, were measured with a custom-made application of Matlab R14. RESULTS: We observed an inclination of the angle mitral annulus/central left ventricle axis, with its lowest point in the direction of the aortic valve (AP plane) of 85 degrees+/-7 degrees in systole (S), 88 degrees+/-8 degrees in early diastole (E), and 88 degrees+/-7 degrees in late diastole (A). In the CC plane, we observed an almost horizontal implantation of 91 degrees+/-5 degrees in systole (S), 91 degrees+/-8 degrees in early diastole (E), and 91 degrees+/-7 degrees in late diastole (A).

Adult↗

Accuracy of 4 different algorithms for the analysis of tomographic radionuclide ventriculography using a physical, dynamic 4-chamber cardiac phantom.

UNLABELLED: Various automatic algorithms are now being developed to calculate left ventricular (LV) and right ventricular (RV) ejection fraction from tomographic radionuclide ventriculography. We tested the performance of 4 of these algorithms in estimating LV and RV volume and ejection fraction using a dynamic 4-chamber cardiac phantom. METHODS: We developed a realistic physical, dynamic 4-chamber cardiac phantom and acquired 25 tomographic radionuclide ventriculography images within a wide range of end-diastolic volumes, end-systolic volumes, and stroke volumes. We assessed the ability of 4 algorithms (QBS, QUBE, 4D-MSPECT, and BP-SPECT) to calculate LV and RV volume and ejection fraction. RESULTS: For the left ventricle, the correlations between reference and estimated volumes (0.93, 0.93, 0.96, and 0.93 for QBS, QUBE, 4D-MSPECT, and BP-SPECT, respectively; all with P < 0.001) and ejection fractions (0.90, 0.93, 0.88, and 0.92, respectively; all with P < 0.001) were good, although all algorithms underestimated the volumes (mean difference [+/-2 SDs] from Bland-Altman analysis: -39.83 +/- 43.12 mL, -33.39 +/- 38.12 mL, -33.29 +/- 40.70 mL, and -16.61 +/- 39.64 mL, respectively). The underestimation by QBS, QUBE, and 4D-MSPECT was greater for higher volumes. QBS, QUBE, and BP-SPECT could also be tested for the right ventricle. Correlations were good for the volumes (0.93, 0.95, and 0.97 for QBS, QUBE, and BP-SPECT, respectively; all with P < 0.001). In terms of absolute volume estimation, the mean differences (+/-2 SDs) from Bland-Altman analysis were -41.28 +/- 43.66 mL, 11.13 +/- 49.26 mL, and -13.11 +/- 28.20 mL, respectively. Calculation of RV ejection fraction correlated well with true values (0.84, 0.92, and 0.94, respectively; all with P < 0.001), although an overestimation was seen for higher ejection fractions. CONCLUSION: Calculation of LV and RV ejection fraction based on tomographic radionuclide ventriculography was accurate for all tested algorithms. All algorithms underestimated LV volume; estimation of RV volume seemed more difficult, with different results for each algorithm. The more irregular shape and inclusion of a relatively hypokinetic RV outflow tract in the right ventricle seemed to cause the greater difficulty with delineation of the right ventricle, compared with the left ventricle.

Algorithms↗

RF-based two-dimensional cardiac strain estimation: a validation study in a tissue-mimicking phantom.

Strain and strain rate imaging have been shown to be useful techniques for the assessment of cardiac function. However, one of the major problems of these techniques is their angle dependency. In order to overcome this problem, a new method for estimating the strain (rate) tensor had previously been proposed by our lab. The aim of this study was to validate this methodology in a phantom setup. A tubular thick-walled tissue-mimicking phantom was fixed in a water tank. Varying the intraluminal pressure resulted in a cyclic radial deformation. The 2D strain was calculated from the 2D velocity estimates, obtained from 2D radio frequency (RF) tracking using a 1D kernel. Additionally, ultrasonic microcrystals were implanted on the outer and inner walls of the tube in order to give an independent measurement of the instantaneous wall thickness. The two methods were compared by means of linear regression, the correlation coefficient, and Bland-Altman statistics. As expected, the strain estimates dominated by the azimuth velocity component were less accurate than the ones dominated by the axial velocity component. Correlation coefficients were found to be r = 0.78 for the former estimates and r = 0.83 was found for the latter. Given that the overall shape and timing of the 2D deformation were very accurate (r = 0.95 and r = 0.84), these results were within acceptable limits for clinical applications. The 2D RF-tracking using a 1D kernel thus allows for 2D, and therefore angle-independent, strain estimation.

Algorithms↗