Virtual Dj Echo Doppler
Herodes Hamilton
Echo-Dynamography (EDG) is a smart visualization technique in echocardiography in which two-dimensional distribution of blood flow vectors in cardiovascular system is deduced by applying fluid dynamics theories into Doppler velocity datasets. Previous validation studies such as numerical simulation of free jet model or model circulation were too simple to reproduce unstable and asymmetrical flow in left ventricle. In the present study, virtual color Doppler echocardiography is generated from PC-MRA (phase contrast magnetic resonance angiography) datasets. EDG is applied on virtual Doppler data and the blood flow vectors are compared with those of the original PC-MRA data. EDG-derived blood flow vectors showed similar pattern as the original PC-MRA data when blood flow velocity had high value. The errors were caused from underestimating the magnitude of vortex flow component in the flow field near the boundary of the left ventricular wall. The results also indicated that apical long axis view had small error compared with parasternal long axis view. Despite EDG method causes small errors, it provides important information on blood flow dynamics in most parts.
Welcome to the Toronto General Hospital Department of Anesthesia and Pain Management Virtual Transesophageal Echocardiography website. This site is intended to be a resource for educators and students looking for tools to facilitate the teaching and learning of transesophageal echocardiography.
A multiphysics simulation approach is developed for predicting cardiac flows as well as for conducting virtual echocardiography (ECHO) and phonocardiography (PC) of those flows. Intraventricular blood flow in pathological heart conditions is simulated by solving the three-dimensional incompressible Navier-Stokes equations with an immersed boundary method, and using this computational hemodynamic data, echocardiographic and phonocardiographic signals are synthesized by separate simulations that model the physics of ultrasound wave scattering and flow-induced sound, respectively. For virtual ECHO, a Doppler ultrasound image is reproduced through Lagrangian particle tracking of blood cell particles and application of sound wave scattering theory. For virtual PC, the generation and propagation of blood flow-induced sounds ('hemoacoustics') is directly simulated by a computational acoustics model. The virtual ECHO is applied to reproduce a color M-mode Doppler image for the left ventricle as well as continuous Doppler image for the outflow tract of the left ventricle, which can be verified directly against clinically acquired data. The potential of the virtual PC approach for providing new insights between disease and heart sounds is demonstrated by applying it to modeling systolic murmurs caused by hypertrophic cardiomyopathy.
The primary challenge in learning TEE is translating the two dimensional echocardiographic image into a visualization of the three-dimensional (3D) structure of the heart. The TEE Standard Views module provides a learning environment where users can view all of the 20 standard TEE positions using two visualization methods simultaneously: (1) a rotatable 3D heart model that includes an echocardiographic plane and (2) the associated TEE clip. The 3-D heart model and echo plane can be rotated, helping students to relate the echocardiographic image to the structures of the heart. Students are also able to remove the part of the heart above the echo plane, revealing the internal structures of the heart that correspond to the TEE image. This resource can be used both by educators for teaching small group sessions and by students for self-study.
VIRTUAL TEE is an online teaching aid designed for use by educators and students of two-dimensional TEE. It is intended to help novice and experienced echocardiographers develop a better understanding of the spatial relationship between ultrasound plane and heart, as well as provide new echocariographers with a structured and logical description of the relationships between the American Society of Echocardiographers (ASE) standard views. Students are able to conduct a virtual TEE study, advancing and rotating the probe and image plane and viewing the resulting TEE images as they conduct the study. They are challenged to position the probe to achieve each of the 20 standard views.
The TEE Alternative Views module provides a learning environment where users can explore 19 non-standard but often used 2D TEE views using two visualization methods simultaneously: (1) a rotatable 3D heart model that includes an echocardiographic plane and (2) the associated TEE clip.
Advanced Echo Online Course features the latest education on established and emerging cardiovascular ultrasound technologies. Combining the course directorships of Echo Hawaii and State-of-the-Art Echocardiography, expert faculty discuss state-of-the-art technologies with a particular focus on how they can be effectively applied in the clinical setting. Case-based approaches are used to discuss new and established applications of echocardiography for diagnosis and guiding management in patients with a broad array of cardiovascular conditions.
Supplemental material, sj-pdf-1-pul-10.1177_2045894020950225 for Virtualechocardiography screening tool to differentiate hemodynamic profiles inpulmonary hypertension by Anjali Vaidya, Jessica R. Golbus, Natasha A. Vedage,Jeremy Mazurek, Farhan Raza and Paul R. Forfia in Pulmonary Circulation
Enrollment criteria. One hundred seventy-nine subjects with pulmonaryhypertension underwent right heart catheterization in pulmonaryhypertension clinic between January 2012 and December 2013. Onehundred fifty-four subjects were eligible for study inclusion. Ofthese, 96 had full echocardiographic parameters included in thevirtual echocardiography screening tool. TTE: transthoracicechocardiogram; RHC: right heart catheterization.
Performance of the virtual echocardiography screening tool forprediction of PHPVD in the original and validationcohorts. Estimated PASP (a) was inferior to the virtualechocardiography screening tool (VEST) (b) for prediction ofPHPVD in the original cohort. VEST was 80.0%sensitive and 75.6% specific for PHPVD with an AUC of0.81. This significantly improved prediction of PHPVDwhen compared to PASPDE which had an AUC of only 0.56.Estimated PASP (c) was inferior to VEST (d) for prediction ofPHPVD in the validation cohort. VEST was 100.0%sensitive and 75.0% specific for PHPVD with an AUC of0.94. This significantly improved prediction of PHPVDwhen compared to PASPDE which had an AUC of only 0.61.PH: pulmonary hypertension; PVD: pulmonary vascular disease; PASP:pulmonary artery systolic pressure; AUC: area under the curve.
Physiologic and clinical PH classifications by the virtualechocardiography screening tool (a, c) versus estimated PASP (b, d).PASP: pulmonary artery systolic pressure; PH: pulmonaryhypertension; PVD: pulmonary vascular disease.
Box plots of hemodynamics by the virtual echocardiography screeningtool versus estimated PASP. Pulmonary capillary wedge pressure(PCWP) (a); transpulmonary gradient (TPG) (b); pulmonary vascularresistance (PVR) (c); estimated pulmonary artery systolic pressure(PASP) by echocardiography (d). Line through the box plot denotesthe median.
This is the first study to describe a novel screening tool that captures patientswith a high likelihood of PHPVD using findings on a standardechocardiogram report. Similarly, this approach identified patients with PH purelyand largely related to passive left heart congestion in the relative absence ofpulmonary vascular disease. By differentiating these two disparate patientphenotypes, additional PH workup and invasive hemodynamic assessment may be appliedmore precisely to the patients with PHPVD, while those withPHLHD may be considered to prioritize targeted treatment towardsalleviating left heart disease as an initial strategy before additional invasivetesting. We propose that implementation of the VEST can be conducted by physiciansremotely and will allow for continued evaluation, minimizing delay, of patients withnewly suspected PH during the Covid-19 era when extensive and invasive diagnostictesting such as RHC is less readily available.
We offer our findings in the spirit of contribution to the already complex clinicalrealm of PH, only further complicated in the Covid-19 era. Our data are in line witha growing body of literature that integration of selected, often easily obtainableechocardiographic variables can provide powerful insight into the hemodynamic basisof PH.6,20,22,23 Our dataextend these observations further, given that the VEST utilizes routinely reportedechocardiographic variables, thus obviating the need for direct image analysis orechocardiographic expertise to apply. As such, VEST enhances the prompt diagnosticabilities of physicians engaged in the growing paradigm of telemedicine and virtualpatient assessment in the Covid-19 era.
We recognize that our study has some limitations that must be considered. Thepatients who contributed to the study were treated at two tertiary referral centerswhich potentially limit the generalizability of our findings. However, wedemonstrated that within PH, there was a diversity of subgroups represented.Further, the VEST uses simple echocardiographic measurements that are consistentwith the American Society of Echocardiography guidelines and should therefore beapplicable across all institutions, regardless of PH expertise or academicenvironment.26,28,29 One advantage of using a small number of centers is theincreased likelihood of uniform data abstraction which may increase the reliabilityof our findings.
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