Phase Analysis for Cardiac Wall Motion Asynchrony Quantification
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Solution Overview
Problem
Current methods for quantifying intraventricular asynchrony in heart failure patients are limited, particularly in those with ventricular conduction delay, as they either lack accuracy or are not applicable to patients with implanted pacemakers, necessitating a more effective technique for predicting the benefit of cardiac resynchronization therapy (CRT) and optimizing therapy parameters.
Innovation Solution
A phase analysis technique that quantifies regional wall motion asynchrony from two-dimensional echocardiographic images, using a system comprising a curve generator, curve offset module, curve averager, curve smoothing module, and phase computer to generate relative phase indicators of cardiac wall motion asynchrony, enabling the prediction of contractile function improvement and identification of optimal therapy candidates.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If traditional methods are used to quantify intraventricular asynchrony, then the measurement may be simple to obtain, but the measurement precision is insufficient and not applicable to patients with implanted pacemakers
Solution Approach 1:
The left ventricle is divided into multiple regional segments (e.g., basal, mid, apical levels across different wall segments) to independently analyze wall motion in each region. This segmentation enables precise quantification of regional asynchrony by comparing phase differences between segments, directly addressing the measurement precision requirement while maintaining systematic analysis.
Solution Approach 2:
Echocardiographic imaging serves as an intermediary modality to non-invasively measure regional wall motion phases. The system uses ultrasound-based echocardiography to capture ventricular wall motion and processes these images through phase analysis algorithms, providing accurate asynchrony quantification without requiring invasive sensors or being contraindicated by implanted pacemakers.
2Measurement precision
If invasive methods are used to measure hemodynamic performance, then the measurement accuracy improves, but the ease of operation and patient comfort deteriorate
Solution Approach 1:
The system replaces invasive mechanical hemodynamic measurement systems with non-invasive echocardiographic imaging and computational phase analysis. By using ultrasound-based mechanical wave propagation to measure wall motion phases and calculating asynchrony indices computationally, the system achieves accurate hemodynamic assessment without catheterization or surgical intervention, significantly improving ease of operation and patient comfort.
Solution Approach 2:
Echocardiographic images serve as an intermediary to indirectly measure hemodynamic performance parameters. Instead of directly measuring pressure or flow with invasive sensors, the system uses wall motion phase delays as a surrogate marker for hemodynamic dysfunction, providing accurate assessment through non-invasive imaging.
3Reliability
If comprehensive therapy optimization is performed to determine optimal CRT parameters, then the therapy effectiveness improves, but the time required for treatment planning increases
Solution Approach 1:
The system performs preliminary phase analysis on baseline echocardiographic images to identify patients with significant intraventricular asynchrony before initiating CRT. By calculating regional phase differences and asynchrony indices in advance, the system pre-screens candidates and predicts likely responders, enabling faster treatment planning and reducing the time needed for therapy optimization while maintaining high selection accuracy.
Solution Approach 2:
The system uses phase angle differences and asynchrony index thresholds as key parameters to objectively classify patients into responder and non-responder categories. By establishing quantitative cutoff values for phase delays between regional segments, the system transforms complex hemodynamic assessment into streamlined parameter-based decision-making, accelerating therapy optimization while preserving reliability.
Data Source
AI summary
A phase analysis technique provides for quantification of regional wall motion asynchrony from endocardial border contours generated from two-dimensional echocardiographic ventricular images. The technique produces results including a degree of radial ventricular asynchrony in heart failure patients with ventricular conduction delay to predict a magnitude of contractile function improvement with pacing therapy. Quantification of change in ventricular regional wall motion asynchrony in response to a therapy provides for a means to identify candidates to receive the therapy and quantitatively predict the benefit of the therapy. Quantification of changes in ventricular regional wall motion asynchrony in response to a sequence of therapies provides for a means to determine an approximately optimal therapy for an intended patient response.