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Abstract: TH-PO750

Quantification of the Effects of a Haemodialysis Patient’s Cardiac Ejection Fraction: Towards Patient Specific Risk Prediction

Session Information

  • Bioengineering
    October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Bioengineering

  • 300 Bioengineering

Authors

  • Kharche, Sanjay R., London Health Sciences Centre, London, Ontario, Canada
  • Xia, Wenyao, Robarts Research Institute, London, Ontario, Canada
  • Kassay, Andrea D., London Health Sciences Centre, London, Ontario, Canada
  • Joseph, Jermiah, London Health Sciences Centre, London, Ontario, Canada
  • McDougall, Kierra D., London Health Sciences Centre, London, Ontario, Canada
  • Peters, Terry M., Robarts Research Institute, London, Ontario, Canada
  • McIntyre, Christopher W., London Health Sciences Centre, London, Ontario, Canada
Background

Hemodialysis (HD) patient hearts suffer chronic ischemia and uremia, leading to contractile dysfunction and arrhythmia risk. Although 2D echocardiography is advanced, image quality is a limiting factor. The black box nature of commercial software is a further challenge. To address these concerns, image analysis-computational tools were developed to produce patient specific structural and functional cardiac models to assist therapy individualisation.

Methods

Echo images from 7 patients were acquired from a previous study. The endocardial and epicardial borders were automatically segmented using our new computer codes. Using the endocardial border, 3D left ventricle chambers were reconstructed for each frame using the modified Simpson’s rule. Normalised chamber volumes were computed from the 3D geometry. Patient specific geometries were encoded into low parameter oblate spheroid structures to permit future assessment of arrhythmia risk of the uremic hearts.

Results

3D geometry reconstruction was successfully implemented in all data sets. A 3D endocardial surface encompassing the left ventricle chamber is shown in Fig. 1, A. The variation of left ventricle volume over one heart beat in one patient is shown in Fig. 1, B. HD reduced ejection fractions (avg. 50% to 44%).

Conclusion

Development of our own codes will permit us to customised analysis on a echocardiographic instrument vendor independent basis. The patient specific structural geometries will provide the essential basis for patient specific contractile and arrhythmia simulated assessment as a next generation tool for dialysis therapy optimisation.

Figure 1. A. Reconstructed 3D LV chamber based on an echo frame. B. LV chamber volume during one heart beat.