Dipartimento di Ingegneria Industriale e dell'Informazione, Università degli Studi di Pavia, Via Ferrata 1, 27100 Pavia, Italy.
Centre for Health Technologies (C.H.T.), Università degli Studi di Pavia, Via Ferrata 1, 27100 Pavia, Italy.
Sci Rep. 2017 Apr 11;7:46143. doi: 10.1038/srep46143.
Mechanical function of the heart during open-chest cardiac surgery is exclusively monitored by echocardiographic techniques. However, little is known about local kinematics, particularly for the reperfused regions after ischemic events. We report a novel imaging modality, which extracts local and global kinematic parameters from videos of in situ beating hearts, displaying live video cardiograms of the contraction events. A custom algorithm tracked the movement of a video marker positioned ad hoc onto a selected area and analyzed, during the entire recording, the contraction trajectory, displacement, velocity, acceleration, kinetic energy and force. Moreover, global epicardial velocity and vorticity were analyzed by means of Particle Image Velocimetry tool. We validated our new technique by i) computational modeling of cardiac ischemia, ii) video recordings of ischemic/reperfused rat hearts, iii) videos of beating human hearts before and after coronary artery bypass graft, and iv) local Frank-Starling effect. In rats, we observed a decrement of kinematic parameters during acute ischemia and a significant increment in the same region after reperfusion. We detected similar behavior in operated patients. This modality adds important functional values on cardiac outcomes and supports the intervention in a contact-free and non-invasive mode. Moreover, it does not require particular operator-dependent skills.
在开胸心脏手术期间,心脏的机械功能仅通过超声心动图技术进行监测。然而,对于缺血事件后再灌注区域的局部运动学,人们知之甚少。我们报告了一种新的成像方式,该方式可从原位跳动心脏的视频中提取局部和整体运动学参数,显示收缩事件的实时视频心电图。定制算法跟踪视频标记的运动,该标记被专门放置在选定区域上,并在整个记录过程中分析收缩轨迹、位移、速度、加速度、动能和力。此外,还通过粒子图像速度测量工具分析了整个心外膜的速度和涡度。我们通过以下方式验证了我们的新技术:i)心脏缺血的计算建模,ii)缺血/再灌注大鼠心脏的视频记录,iii)冠状动脉旁路移植术前和术后跳动人心的视频,以及 iv)局部弗兰克-斯塔林效应。在大鼠中,我们观察到急性缺血期间运动学参数的减少,以及再灌注后同一区域的显著增加。我们在手术患者中也检测到了类似的行为。这种方式增加了对心脏功能的重要功能价值,并支持以非接触和非侵入性的方式进行干预。此外,它不需要特别依赖操作者的技能。