Three-dimensional mapping of mechanical activation patterns, contractile dyssynchrony and dyscoordination by two-dimensional strain echocardiography: Rationale and design of a novel software toolbox

doi:10.1186/1476-7120-6-22

Cardiovascular Ultrasound

Volume 6

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De Boeck BW
Kirn B
Teske AJ
Hummeling RW
Doevendans PA
Cramer MJ
Prinzen FW

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Kirn B
Teske AJ
Hummeling RW
Doevendans PA
Cramer MJ
Prinzen FW
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Three-dimensional mapping of mechanical activation patterns, contractile dyssynchrony and dyscoordination by two-dimensional strain echocardiography: Rationale and design of a novel software toolbox

Bart WL De Boeck¹ , Borut Kirn² , Arco J Teske¹ , Ralph W Hummeling³ , Pieter A Doevendans¹ , Maarten J Cramer¹ and Frits W Prinzen²

¹Department of Cardiology, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands

²Department of Physiology, University of Maastricht, Cardiovascular Research Institute Maastricht, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands

³Protys BV, Radex Innovation Centre, Rotterdamseweg 183c, 2629 HD Delft, The Netherlands

author email corresponding author email

Cardiovascular Ultrasound 2008, 6:22doi:10.1186/1476-7120-6-22


Published:	30 May 2008

Additional files

Additional file 1:

Algorithm 1: RR-normalization. The file describes the algorithm implemented in Matlab to time-normalize different deformation curves to a single, common reference RR-interval.

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Additional file 2:

Algorithm 2: Internal Strain Fraction and vector of paradoxical strain-rate behavior (PSrV). The file describes the basic principle and practical implementation of two novel indices of dyscoordination, ISF and PSrV, into STOUT.

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Additional file 3:

Example of a PSrV plot in a normal individual and a patient with WPW. The plot displays the vector magnitude of paradoxical strain-rate in the horizontal plane at 20 ms time-steps. Paradoxical deformation behaviour will increase the magnitude (and R²of the estimation) of the vector when it is more vigorous, when it encompasses a more extensive area or both, unless it is due to random noise. Unreliable vectors (R²< 0.40) have been omitted. The presence of a highly reliable and large PSrV before mitral valve closure (MVO) is seen only in the WPW-ventricle (arrow), indicating vigorous shortening during late atrial filling with a well organized spatial pattern. This corresponds to premature shortening in the pre-excited area while in other area's stretching from the atrial contraction is ongoing.

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Additional file 4:

Comparison of commonly used echocardiographic techniques/indices to evaluate mechanical dyssynchrony with STOUT-indices. A table outlining the main theoretical and technical advantages of a STOUT-based approach over more conventional echocardiographic techniques to study dyssynchrony.

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