Abstract
The coronary microcirculation (CM) plays a critical role in the regulation of blood flow and nutrient exchange to support the viability of the heart. In many disease states, the CM becomes structurally and functionally impaired, and transthoracic Doppler echocardiography can be used as a non-invasive surrogate to assess CM disease. Analysis of Doppler echocardiography is prone to user bias and can be laborious, especially if additional parameters are collected. We hypothesized that we could develop a MATLAB algorithm to automatically analyze clinically-relevant and non-traditional parameters from murine PW Doppler coronary flow patterns that would reduce intra- and inter-operator bias, and analysis time. Our results show a significant reduction in intra- and inter-observer variability as well as a 30 fold decrease in analysis time with the automated program vs. manual analysis. Finally, we demonstrated good agreement between automated and manual analysis for clinically-relevant parameters under baseline and hyperemic conditions. Resulting coronary flow velocity reserve calculations were also found to be in good agreement. We present a MATLAB algorithm that is user friendly and robust in defining and measuring Doppler coronary flow pattern parameters for more efficient and potentially more insightful analysis assessed via Doppler echocardiography.
Highlights
The coronary microcirculation (CM) is unique in physiologic structure and function compared to other microvascular beds
We aimed to develop a MATLAB program that would (1) automatically extract existing and clinically utilized parameters of murine coronary TTDE flow patterns such as peak velocity (PV), heart rate (HR), and velocity-time integral (VTI) as well as newly-defined times, velocities, and slopes, from raw exported video files and (2) automatically perform calculations to obtain parameter averages and coronary flow velocity reserve (CFVR) per animal
PV, HR, and VTI results under baseline and hyperemic conditions are presented below as they are the most frequently measured in clinical practice
Summary
The coronary microcirculation (CM) is unique in physiologic structure and function compared to other microvascular beds It plays a critical role in the regulation of blood flow and nutrient exchange to support the viability of the heart. Because this vasculature lies within the surrounding myocardium, it constantly experiences transmural forces in the form of systolic contraction and diastolic relaxation with every cardiac cycle. Transthoracic Doppler Echocardiography (TTDE) has proven to be a useful and relatively inexpensive tool to non-invasively assess cardiac perfusion by measuring parameters such as coronary flow velocity reserve (CFVR) and velocity-time integral (VTI)[2,3,4,5,6]. Creating an automated or nearly automated algorithm to analyze CFPs would reduce user bias, allow for the analysis of many more cardiac cycles, and reduce manual labor
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