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New approach to describe cardiac mechanics and its pumping and regulating functions

The goal of this project is to develop and validate a new visualization system, i.e. a state diagram, as a sensitive tool for verifying changes of the heart mechanical pump- and regulating functioning.

A state diagram of a healthy subject to the left and of a patient with cardiac dyssynchrony to the right. The dyssynchrony between different cardiac segments is visualized at the bottom in the left figure.

Methods

The state diagram idea follows a long period of research by Stig Lundbäck (1984) concerning the heart mechanics and is based on a novel pump principle (DAPP) that considers the valve plane motion as the main contribution to the heart pumping action. We have developed a software platform for advanced analysis of the heart mechanical pump- and regulating functions. The data necessary to produce the state diagram can be captured in different modalities, e.g. from Tissue Velocity Imaging (TVI), which allows accurate measurement of myocardial functions, from pressure devices, from acceleration sensors etc. Robust algorithms for automatic detection of interest points in velocity data are being developed.

Results

Cardiac time intervals have been described as measure of cardiac performance, where prolongation, shortening and delay of the different time intervals have been evaluated as markers of cardiac dysfunction. In the state diagram, the cardiac events are detected and displayed in an easy to interpret form. Clinical studies demonstrated that the state diagram has potential to be used for visualization of various cardiac dysfunctions and it demonstrated to be a more sensitive tool for detection of non ST-elevation myocardial infarction compared to other established echocardiographic indexes. Furthermore, the state diagram together with TVI measurements can help the optimization of pacemaker settings.

Collaborations

This is a collaboration project between STH (School of Technology and health, KTH) and Gripping Heart AB.

Contact persons

Search words

State diagram, heart mechanics, echocardiography, pacemaker optimization