Assessment of Phasic Changes of Vascular Size by Automated Edge Tracking-State of the Art and Clinical Perspectives.

Luca Mesin,Gianluca Leonardi,Pierpaolo Pellicori,Massimo Porta,Leonardo Ermini,Andrea Grillo,Davide Stolfo,Gianfranco Sinagra,Piero Policastro,Roberto Bini,Alberto Giannoni,Bruno Fabris,Carlo Albera,Stefano Albani,Antonio Pepe,Silvestro Roatta,Paolo Pasquero,Stefano Seddone,Chiara Melchiorri,Paolo Scacciatella,Francesco Antonini‐Canterin

doi:10.3389/fcvm.2021.775635

Abstract

Assessment of vascular size and of its phasic changes by ultrasound is important for the management of many clinical conditions. For example, a dilated and stiff inferior vena cava reflects increased intravascular volume and identifies patients with heart failure at greater risk of an early death. However, lack of standardization and sub-optimal intra- and inter- operator reproducibility limit the use of these techniques. To overcome these limitations, we developed two image-processing algorithms that quantify phasic vascular deformation by tracking wall movements, either in long or in short axis. Prospective studies will verify the clinical applicability and utility of these methods in different settings, vessels and medical conditions.

Highlights

The invasive measurement of central venous pressure (CVP) to estimate right atrial pressure (RAP) is routinely used only in critically ill patients to assess cardiac hemodynamics and volume status
Our preliminary results suggest that the integration of indexes extracted by both algorithms could provide a more reliable estimation of the volemic status than using the standard inferior vena cava (IVC) assessment [26] and call for extensions of research to larger databases and other vessels, like the arteries, the evaluation of which might improve cardiovascular risk stratification [27]
Two main contributions are clearly visible in IVC dynamics described by those time series: a slow oscillation of IVC size induced by respiration and another at higher frequency induced by the heartbeats

Summary

INTRODUCTION

The invasive measurement of central venous pressure (CVP) to estimate right atrial pressure (RAP) is routinely used only in critically ill patients to assess cardiac hemodynamics and volume status. Our preliminary results suggest that the integration of indexes extracted by both algorithms could provide a more reliable estimation of the volemic status than using the standard IVC assessment [26] and call for extensions of research to larger databases and other vessels, like the arteries, the evaluation of which might improve cardiovascular risk stratification [27]. In this manuscript, we discuss these methods along with some possible future applications

PHYSIOLOGICAL BASIS OF VESSEL PULSATILITY

ECHOGRAPHY PROCESSING

CURRENT AND FUTURE APPLICATIONS

CONCLUSIONS

PATENTS