Abstract
Current guidelines for measuring cardiac function by tissue Doppler recommend using multiple beats, but this has a time cost for human operators. We present an open-source, vendor-independent, drag-and-drop software capable of automating the measurement process. A database of ~8000 tissue Doppler beats (48 patients) from the septal and lateral annuli were analyzed by three expert echocardiographers. We developed an intensity- and gradient-based automated algorithm to measure tissue Doppler velocities. We tested its performance against manual measurements from the expert human operators. Our algorithm showed strong agreement with expert human operators. Performance was indistinguishable from a human operator: for algorithm, mean difference and SDD from the mean of human operators’ estimates 0.48 ± 1.12 cm/s (R2 = 0.82); for the humans individually this was 0.43 ± 1.11 cm/s (R2 = 0.84), −0.88 ± 1.12 cm/s (R2 = 0.84) and 0.41 ± 1.30 cm/s (R2 = 0.78). Agreement between operators and the automated algorithm was preserved when measuring at either the edge or middle of the trace. The algorithm was 10-fold quicker than manual measurements (p < 0.001). This open-source, vendor-independent, drag-and-drop software can make peak velocity measurements from pulsed wave tissue Doppler traces as accurately as human experts. This automation permits rapid, bias-resistant multi-beat analysis from spectral tissue Doppler images.
Highlights
Tissue doppler imaging (TDI) is an echocardiographic technique that can assess left ventricular systolic and diastolic function [1,2,3,4]
97% of the beats measured by the automatic algorithm were measured by at least one human operator. 96% of the beats measured by at least one operator were measured by the automated algorithm
Focused echocardiography could benefit from this automated technology since it might allow non-specialists to obtain key velocity measurements and provide a rapid quantitative assessment of indices of left ventricular function [29]
Summary
Tissue doppler imaging (TDI) is an echocardiographic technique that can assess left ventricular systolic and diastolic function [1,2,3,4]. It has diagnostic and prognostic utility across a wide range of scenarios including heart failure, cardiomyopathy and valvular disease [5,6,7,8,9,10]. Current guidelines suggest measuring and averaging at least three consecutive beats for tissue Doppler velocity measurements [1,2,3] This may improve the precision of the measurement, asking humans to make multiple manual measurements from tissue Doppler traces is timeconsuming and disruptive to workflow. We developed, tested and evaluated a vendor-independent solution to make reproducible, bias-resistant, multi-beat tissue Doppler measurements
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