Publications (14)71.04 Total impact
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Article: Response to letter regarding article, “magnetic resonance imaging with 3-dimensional analysis of left ventricular remodeling in isolated mitral regurgitation: implications beyond dimensions”.
Circulation 02/2013; 127(7):e462. · 14.74 Impact Factor -
Article: Importance of Three-Dimensional Geometric Analysis in the Assessment of the Athlete's Heart.
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ABSTRACT: How the left ventricle remodels in response to a high-volume stimulus is important in evaluating the endurance athlete's heart. Marathoners and patients with isolated, moderate chronic compensated mitral regurgitation (MR) represent physiologic and pathologic forms of eccentric left ventricular (LV) remodeling in response to intermittent and chronic volume overload, respectively. Thus, in this study, magnetic resonance imaging with tissue tagging and 3-dimensional data analysis at rest were performed in 19 marathoners (mean age 39 ± 10 years, 47% women), 17 patients with isolated MR without coronary artery disease or medical therapy (mean age 46 ± 5 years, 53% women), and 24 controls (mean age 45 ± 8 years, 50% women). Marathoners and patients with MR had approximately 35% greater LV end-diastolic volume indexes, approximately 50% greater end-systolic volume indexes, and approximately 34% greater LV stroke volume indexes (p <0.0001) compared to controls. However, marathoners' hearts had increased long-axis length, while those of patients with MR did not differ from the hearts of controls. The hearts of patients with MR had greater LV global and apex sphericity compared to those of marathoners and controls (p <0.0001). Marathoners had normal LV mass/volume ratios and wall thicknesses, whereas these were significantly decreased in the MR group. In marathoners, the baseline LV work rate was similar to that in controls and higher in patients with MR compared to controls. In conclusion, marathoners' hearts achieve elevated stroke volume at rest with adherence to an elliptical shape defined by 3-dimensional geometry and mass/volume ratio. Thus, a comprehensive evaluation of LV geometry and mass/volume ratio may be important in the evaluation of the athlete's heart.The American journal of cardiology 01/2013; · 3.58 Impact Factor -
Article: Magnetic resonance imaging with 3-dimensional analysis of left ventricular remodeling in isolated mitral regurgitation: implications beyond dimensions.
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ABSTRACT: Although surgery is indicated in patients with mitral regurgitation (MR) when left ventricular (LV) end-systolic (LVES) dimension is >40 mm, LV ejection fraction may decrease after mitral valve surgery. We hypothesize that significant LV remodeling before surgery is not reflected by standard echocardiographic parameters measured at the base of the heart. Ninety-four patients (age, 54 ± 11 years; 38% female) with degenerative isolated MR underwent cine magnetic resonance imaging with tissue tagging and 3-dimensional analysis. In 51 control subjects (age, 44 ± 14 years; 53% female), the relation between LVES volume (LVESV) and LVES dimension was quadratic, whereas in 94 MR patients, this relation was cubic, indicating a greater increase in LVESV per LVES dimension among MR patients. Moreover, magnetic resonance imaging LVESV from summated serial short-axis slices was significantly greater than LVESV assessed with the Bullet formula in MR patients, attributed to a more spherical remodeling distal to the tips of the papillary muscles (P<0.001). Thirty-five patients underwent mitral valve repair per current guideline recommendations. LV ejection fraction decreased from 61 ± 7% to 54 ± 8% (P<0.0001) and maximum shortening decreased significantly below normal at 1 year postoperatively (P<0.0001). Despite normalization of LV stroke volume and LV end-diastolic volume/mass ratio, there was a persistent significant increase in distal LVES 3-dimensional radius/wall thickness ratio and LVESV index after surgery. Despite apparently preserved LVES dimension, MR patients demonstrate significant spherical mid to apical LVES remodeling that contributes to higher LVESV than predicted by standard geometry-based calculations. Decreased LV strain after surgery suggests that a volumetric analysis of LV remodeling and function may be preferred to evaluate disease progression in isolated MR.Circulation 04/2012; 125(19):2334-42. · 14.74 Impact Factor -
Article: Relation of torsion and myocardial strains to LV ejection fraction in hypertension.
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ABSTRACT: The goal of this study was to define the mechanism of preserved ejection fraction (EF) despite depressed myocardial strains in hypertension (HTN). Concentric left ventricular (LV) remodeling in HTN may have normal or supranormal EF despite depressed myocardial strains. The reason for such discordance is not clear. The aim of this study was to comprehensively evaluate the LV mechanics in a well-defined HTN population to define underlying reasons for such a paradox. Sixty-seven patients with resistant HTN and 45 healthy control subjects were studied by cardiac magnetic resonance imaging and tissue tagging with 3-dimensional analysis. Amplitude and directional vector of longitudinal (Ell), circumferential (Ecc), and principal strain for maximal shortening (E3) were computed at basal, mid, and distal LV levels, respectively. LV torsion, defined as the rotation angle of apex relative to base, and LV twist, which accounts for the effects of differential LV remodeling on torsion for comparison among the 2 groups, were also calculated. LV mass index and LV mass/LV end-diastolic volume ratio were significantly higher in the HTN group compared with controls, consistent with concentric LV remodeling. Ell and Ecc were significantly decreased in amplitude with altered directional vector in HTN compared with controls. However, the amplitude of E3 was similar in the 2 groups. Torsion and twist were significantly higher in HTN, which was mainly due to increase in apical rotation. The HTN group demonstrated significantly increased LV wall thickening compared with controls that resulted in greater LVEF in the HTN group compared with controls (70% vs. 65%, p < 0.001, respectively). In compensated LV remodeling secondary to HTN, there is increased LV wall thickening with preserved E3 and increased torsion compared with normal controls. This, therefore, contributes to supranormal LVEF in HTN despite depressed longitudinal and circumferential strains.JACC. Cardiovascular imaging 03/2012; 5(3):273-81. · 14.29 Impact Factor -
Article: Oxidative stress and myocardial remodeling in chronic mitral regurgitation.
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ABSTRACT: Mechanisms of left ventricular (LV) dysfunction in isolated mitral regurgitation (MR) are not well understood. Vasodilator therapy in other forms of LV dysfunction reduces LV wall stress and improves LV function; however, studies in isolated MR show no beneficial effect on LV remodeling using vasodilator drugs or renin-angiotensin system blockade. Therefore, the search for new therapies that improve LV remodeling and function in isolated MR is clinically significant. Recent work in the authors' laboratory has demonstrated increased oxidants from a number of sources including the enzyme xanthine oxidase (XO) in the LV of patients with isolated MR. In addition to being a major source of reactive oxygen species, XO is linked to bioenergetic dysfunction because its substrates derive from adenosine triphosphate catabolism. Correspondingly, there was also evidence of aggregates of small mitochondria in cardiomyocytes, which is generally considered a response to bioenergetic deficit in cells. Future studies are required to determine whether XO and persistent oxidative stress are causative in maladaptive LV remodeling and offer potential therapeutic targets in ameliorating LV damage in patients with isolated MR.The American Journal of the Medical Sciences 08/2011; 342(2):114-9. · 1.39 Impact Factor -
Article: Three-dimensional plus time biventricular strain from tagged MR images by phase-unwrapped harmonic phase.
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ABSTRACT: To validate a method called bi-ventricular strain unwrapped phase (BiSUP) for reconstructing three-dimensional plus time (3D+t) biventricular strain maps from phase-unwrapped harmonic phase (HARP) images derived from tagged cardiac magnetic resonance imaging (MRI). A set of 30 human subjects were imaged with tagged MRI. In each study, HARP phase was computed and unwrapped in each short-axis and long-axis image. Inconsistencies in unwrapped phase were resolved using branch cuts manually placed with a graphical user interface. The 3D strain maps were computed independently in each imaged time frame through systole and mid diastole in each study. The BiSUP strain and displacements were compared with those estimated by a 3D feature-based (FB) technique and a 2D+t HARP technique. The standard deviation of the difference between strains measured by the FB and the BiSUP methods was less than 4% of the average of the strains from the two methods. The correlation between peak minimum principal strain measured using the BiSUP and HARP techniques was over 83%. The BiSUP technique can reconstruct full 3D+t strain maps from tagged MR images through the cardiac cycle in a reasonable amount of time and user interaction compared with other 3D analysis methods.Journal of Magnetic Resonance Imaging 07/2011; 34(4):799-810. · 2.70 Impact Factor -
Article: 3D left ventricular strain from unwrapped harmonic phase measurements.
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ABSTRACT: To validate a method for measuring 3D left ventricular (LV) strain from phase-unwrapped harmonic phase (HARP) images derived from tagged cardiac magnetic resonance imaging (MRI). A set of 40 human subjects were imaged with tagged MRI. In each study the HARP phase was computed and unwrapped in each short-axis and long-axis image. Inconsistencies in unwrapped phase were resolved using branch cuts manually placed with a graphical user interface. 3D strain maps were computed for all imaged timeframes in each study. The strain from unwrapped phase (SUP) and displacements were compared to those estimated by a feature-based (FB) technique and a HARP technique. 3D strain was computed in each timeframe through systole and mid-diastole in approximately 30 minutes per study. The standard deviation of the difference between strains measured by the FB and the SUP methods was less than 5% of the average of the strains from the two methods. The correlation between peak circumferential strain measured using the SUP and HARP techniques was over 83%. The SUP technique can reconstruct full 3D strain maps from tagged MR images through the cardiac cycle in a reasonable amount of time and user interaction compared to other 3D analysis methods.Journal of Magnetic Resonance Imaging 04/2010; 31(4):854-62. · 2.70 Impact Factor -
Article: Measurement of transient deformations using digital image correlation method and high-speed photography: application to dynamic fracture.
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ABSTRACT: The digital image correlation method is extended to the study of transient deformations such as the one associated with a rapid growth of cracks in materials. A newly introduced rotating mirror type, multichannel digital high-speed camera is used in the investigation. Details of calibrating the imaging system are first described, and the methodology to estimate and correct inherent misalignments in the optical channels are outlined. A series of benchmark experiments are used to determined the accuracy of the measured displacements. A 2%-6% pixel accuracy in displacement measurements is achieved. Subsequently, the method is used to study crack growth in edge cracked beams subjected to impact loading. Decorated speckle patterns in the crack tip vicinity at rates of 225,000 frames per second are registered. Two sets of images are recorded, one before the impact and another after the impact. Using the image correlation algorithms developed for this work, the entire crack tip deformation history, from the time of impact to complete fracture, is mapped. The crack opening displacements are then analyzed to obtain the history of failure characterization parameter, namely, the dynamic stress intensity factor. The measurements are independently verified successfully by a complementary numerical analysis of the problem.Applied Optics 09/2007; 46(22):5083-96. · 1.41 Impact Factor -
Article: Effect of primary mitral regurgitation on left ventricular synchrony.
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ABSTRACT: Mitral regurgitation (MR) promotes left ventricular (LV) dilatation and eccentric remodeling. In the presence of LV dyssynchrony and heart failure, cardiac resynchronization therapy decreases the severity of MR. Whether primary MR can cause LV dyssynchrony is unknown. We investigated whether moderate to severe primary MR causes LV dyssynchrony in the presence of LV dilation and an ejection fraction (EF) >55%. We studied 37 normal subjects and 22 patients with moderate to severe MR and no coronary artery disease. Electrocardiographically gated cine and tagged cardiac magnetic resonance imaging was performed. Two-dimensional, maximum-circumferential shortening strain and time-to-peak strain (TTPS) were computed using harmonic-phase analysis of tagged magnetic resonance imaging. LV dyssynchrony was assessed by comparing TTPS delay of various LV quadrants and TTPS dispersion among the contralateral quadrants in patients with MR and normal subjects. Statistical comparison was done using a generalized linear model for repeated measurements. LV end-diastolic and LV end-systolic volumes were significantly larger in patients with MR versus normal subjects (207 +/- 11 vs 130 +/- 4 and 73 +/- 5 vs 47 +/- 2 ml, p <0.001). LVEF did not differ in patients with MR and normal subjects. The difference in the TTPS among various quadrants and the dispersion among the contralateral quadrants of the LV myocardium was similar between patients with MR and normal subjects. In conclusion, moderate to severe MR does not cause LV dyssynchrony in patients with LV dilatation and normal LVEF. Thus, cardiac resynchronization therapy in the absence of LV dyssynchrony may not decrease the severity of MR.The American Journal of Cardiology 08/2007; 100(4):707-11. · 3.37 Impact Factor -
Article: Left ventricular motion reconstruction with a prolate spheroidal B-spline model.
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ABSTRACT: Tagged cardiac magnetic resonance (MR) imaging can non-invasively image deformation of the left ventricular (LV) wall. Three-dimensional (3D) analysis of tag data requires fitting a deformation model to tag lines in the image data. In this paper, we present a 3D myocardial displacement and strain reconstruction method based on a B-spline deformation model defined in prolate spheroidal coordinates, which more closely matches the shape of the LV wall than existing Cartesian or cylindrical coordinate models. The prolate spheroidal B-spline (PSB) deformation model also enforces smoothness across and can compute strain at the apex. The PSB reconstruction algorithm was evaluated on a previously published data set to allow head-to-head comparison of the PSB model with existing LV deformation reconstruction methods. We conclude that the PSB method can accurately reconstruct deformation and strain in the LV wall from tagged MR images and has several advantages relative to existing techniques.Physics in Medicine and Biology 03/2006; 51(3):517-37. · 2.83 Impact Factor -
Article: Combined tag tracking and strain reconstruction from tagged cardiac MR images without user-defined myocardial contours.
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ABSTRACT: To develop an unsupervised method for measuring quantitative three-dimensional regional strain in the left ventricular wall from tagged cardiac MR images. A total of 10 normal human volunteers and eight patients with myocardial infarction were imaged using a parallel tagged imaging protocol. Each study was analyzed using the combined tag tracking and strain reconstruction (COTTER) algorithm. In contrast to existing techniques, which first track tag lines independently in each slice, then reconstruct myocardial deformation, the COTTER algorithm fits a three-dimensional cardiac deformation model directly to the image data. This approach ensures that tag line positions identified in the image data are consistent from slice to slice. A total of 10 imaging studies (six normals, four patients) were used to optimize parameters of the COTTER algorithm. In the remaining eight imaging studies, the root-mean-square difference between tags tracked by COTTER and user-supervised analysis was 0.66 pixels at end-systole. The correlation coefficient between circumferential shortening strains at end-systole computed by COTTER and user-supervised analysis was 0.84 (P < 0.005) at the midwall. The COTTER algorithm can compute accurate measurements of three-dimensional regional strain without user supervision.Journal of Magnetic Resonance Imaging 02/2005; 21(1):12-22. · 2.70 Impact Factor -
Article: Three-dimensional myocardial strain reconstruction from tagged MRI using a cylindrical B-spline model.
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ABSTRACT: In this paper, we present a new method for reconstructing three-dimensional (3-D) left ventricular myocardial strain from tagged magnetic resonance (MR) image data with a 3-D B-spline deformation model. The B-spline model is based on a cylindrical coordinate system that more closely fits the morphology of the myocardium than previously proposed Cartesian B-spline models and does not require explicit regularization. Our reconstruction method first fits a spatial coordinate B-spline displacement field to the tag line data. This displacement field maps each tag line point in the deformed myocardium back to its reference position (end-diastole). The spatial coordinate displacement field is then converted to material coordinates with another B-spline fit. Finally, strain is computed by analytically differentiating the material coordinate B-spline displacement field with respect to space. We tested our method with strains reconstructed from an analytically defined mathematical left ventricular deformation model and ten human imaging studies. Our results demonstrate that a quadratic cylindrical B-spline with a fixed number of control points can accurately fit a physiologically realistic range of deformations. The average 3-D reconstruction computation time is 20 seconds per time frame on a 450 MHz Sun Ultra80 workstation.IEEE Transactions on Medical Imaging 08/2004; 23(7):861-7. · 3.64 Impact Factor -
Article: Unsupervised reconstruction of a three-dimensional left ventricular strain from parallel tagged cardiac images.
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ABSTRACT: A new algorithm, called the Unsupervised Tag ExTraction and Heart strain(E) Reconstruction (UNTETHER) algorithm, is presented for quantifying three-dimensional (3D) myocardial strain in tagged cardiac MR images. Five human volunteers and five postinfarct patients were imaged. 3D strains measured by UNTETHER and a user-supervised technique were compared. Each study was analyzed in 49 +/- 8 min with UNTETHER, compared to approximately 4 hr with the user-supervised technique. For pooled human data, the correlation coefficient between the two methods for circumferential shortening (E(cc)) was r = 0.91 at the mid-wall (P < 0.0005). UNTETHER is capable of measuring wall motion abnormalities resulting from coronary artery disease, and has the potential to overcome the main limitations (time and user-supervision requirements) to routine clinical use of tagged cardiac MRI.Magnetic Resonance in Medicine 04/2003; 49(4):743-54. · 2.96 Impact Factor -
Article: Joint Reconstruction of 2-D Left Ventricular Displacement and Contours from Tagged Magnetic Resonance Images Using Markov Random Field Edge Prior
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ABSTRACT: Magnetic Resonance (MR) tagging has been shown to be a useful method for non-invasively measuring the deformation of the left ventricle (LV), during the cardiac cycle. By reconstructing a displacement field based on the movement of the tag lines, one can compute myocardial contraction measures such as strain. Existing methods depend on user-defined LV contours, which require human intervention and are therefore the biggest bottleneck in the reconstruction process. In this paper we present a method for reconstructing 2-D LV deformation without user-defined contours. We use a compound Gauss-Markov random field to model the 2-D vector displacement field, which is parameterized by two closed and smooth contours. By iteratively optimizing the contours, the displacement field, and the parameters, we obtain an estimate of the displacement field and the contours. Experimental results on in vivo human data are presented that demonstrate the accuracy of our algorithm. 1. Introduction Magnetic r...05/1999;
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2003–2011
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Auburn University
- Department of Electrical & Computer Engineering
Auburn, AL, USA
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