Document Detail


An echocardiogram-based 16-segment model for predicting left ventricular ejection fraction improvement.
MedLine Citation:
PMID:  15064079     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
An important goal of cardiac revascularization is to improve the left ventricular ejection fraction, which is an important clinical determinant of the long-term outcome for patients with coronary artery disease. Regional myocardium function improvement may be expected from revascularization when viable myocardium is detected using non-invasive cardiac imaging. However, the quantitative relation between regional myocardial function recovery and global heart function improvement has not been determined and there is no tool to predict the amount of ejection fraction improvement prior to revascularization. A 16 segment biomechanical model of the left ventricle is proposed to establish the relationship between the ejection fraction improvement and the viable segments detected by echocardiography. With the assumption that the viable segments would potentially improve contractility after revascularization, the ejection fraction improvement is estimated for all possible wall motion score improvement in viable segments. The model shows that the ejection fraction improvement is linearly related to the contractility in the normal segments and a weighted sum of the numbers of viable segments that recover to normal or hypokinetic contractility. The predictive value of the model is illustrated for a group of patients reported in the literature. The model predictions of the post-revascularization ejection fraction are very close to the follow-up data with a very strong correlation (R2 = 0.92). By predicting the ejection fraction improvement, the model may provide a tool for evaluating the efficacy of revascularization and for selecting patients who would benefit from revascularization.
Authors:
Hai-Chao Han
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Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  Journal of theoretical biology     Volume:  228     ISSN:  0022-5193     ISO Abbreviation:  J. Theor. Biol.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-04-05     Completed Date:  2004-08-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376342     Medline TA:  J Theor Biol     Country:  England    
Other Details:
Languages:  eng     Pagination:  7-15     Citation Subset:  IM    
Affiliation:
Department of Mechanical Engineering and Biomechanics, University of Texas at San Antonio, San Antonio, TX 78249, USA. hchan@utsa.edu
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MeSH Terms
Descriptor/Qualifier:
Coronary Disease / physiopathology,  surgery,  ultrasonography*
Humans
Models, Cardiovascular*
Myocardial Contraction
Myocardial Revascularization*
Myocardial Stunning / ultrasonography
Patient Selection
Postoperative Period
Prognosis
Stroke Volume*
Treatment Outcome
Ventricular Dysfunction, Left / etiology,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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