Detection of chronic heart failure in children with congenital heart disease with innovative ultrasound techniques
11 / 2004 - 12 / 2008
In children with a congenital heart disease, functional malformations which may lead to chronic heart failure are often present. Although echocardiography is a well-established clinical tool in pediatric cardiology, it does not provide quantitative information on locally disturbed mechanical properties of the myocard nor on its possible cause i.e. the formation of fibrosis. Furthermore, the presently available two-dimensional information is not sufficient to assess the exact geometry of the heart with congenital malformations. The primary focus is on three/four-dimensional functional characterization of the myocard using ultrasound strain(-rate) imaging and ultrasound spectroscopy. The first parameter provides the cyclic deformation of the myocardium, the latter parameter is associated with changes in the structural composition of the myocard. The innovation of the project is that the strain(-rate) will be determined in three dimensions versus time using the rf-signal and will be combined with spectroscopy. Estimation of the three components of the strain(-rate) vector is not described in literature but is required since the heart is a complex structure composed of non-isotropic muscular tissue, requiring knowledge of the strain in all dimensions. The second focus is on real-time three-dimensional imaging of the heart. Software for automated myocardial boundary detection and segmentation will be developed and validated. This technique will optimize the identification and functional quantification of congenital malformations as well as assess the translation and rotation of the heart. Combination of strain(-rate), spectroscopy, and segmentation in four dimensions (three dimensions versus time) may provide a method to identify the time-point at which reversible hypertrophy changes into irreversible damage due to fibrosis formation and may be used to decide on timely treatment or intervention, thus preventing heart failure. The final goal is to evaluate the developed techniques in selected patient groups.