Left ventricular ejection fraction (LVEF) is a key indicator of cardiac function assessed via echocardiography. The biplane Simpson's method for manual measurement is time-consuming and subjective, requiring identification of apical four-chamber (A4C) and two-chamber (A2C) views at end-diastolic (ED) and end-systolic (ES) frames. Automated methods often struggle with consistency and reliability, particularly in heart failure, arrhythmia and low signal-to-noise ratio (SNR) conditions. To address these challenges, this study presents EchoSegPhaseNet (ESP Net), an innovative automated approach for LVEF measurement using multi-frame temporal aggregation. ESP Net comprises two main components: the PhaseFormer module for cardiac phase detection and the LVFormer for Endo segmentation. PhaseFormer significantly improves ED/ES frame prediction accuracy, primarily due to the Multi Probability Prediction Head (MPP), which enables long range temporal receptive fields and effectively aggregates deep-layer features over various distances in the echocar diographic video stream. Following this, LVFormer aggregates deep temporal features from frames around ED/ES, combining spatial-temporal features from one complete respective cardiac cycle of both A2C and A4C views to overcome single-view limitations and significantly enhance segmentation accuracy. This upstream-downstream pro cessing pipeline significantly boosts data processing efficiency. In evaluations on both private and public datasets, ESPNet showcases a faster inference speed in phase detection compared to existing methods, while maintaining similar accuracy levels. In the Endo segmentation task, it not only achieves superior speed but also outperforms current methods in accuracy, with a Pearson correlation coefficient of 0.981, an R2 of 0.96, and a mean absolute error of 3.281 between automated LVEF measurements and manual physician calculations. These results demonstrate that ESPNet not only outperforms existing methods but also achieves a level of consistency comparable to inter observer variability among mid-career clinicians, effectively addressing the clinical need for reliable and efficient automated LVEF measurement.
Chunjie Shan, Guanjun Guo, Zhongqing Shi et al.· IEEE journal of biomedical a...· 0 citations
Background Ventricular pre-excitation can cause left ventricular (LV) mechanical dyssynchrony and dysfunction. However, the specific impact of accessory pathway (AP) location on LV mechanics remains incompletely characterized. This study utilized two-dimensional speckle-tracking echocardiography (2D-STE) to quantify and compare LV deformation and synchrony across these anatomical subgroups. Methods We retrospectively analyzed 91 patients with Wolff-Parkinson-White (WPW) syndrome (age 38.2±1.4 years) and 56 matched controls using 2D-STE. Global and regional LV deformation and synchrony were compared across AP-location groups: septal (n=34), right (n=38), and left (n=19). LV deformation parameters included circumferential strain (CS), longitudinal strain (LS), and radial strain (RS). LV synchrony was assessed by peak strain dispersion (PSD) of LV segments for each strain direction. Results All patient groups (septal: −19.0%±0.7%, right: −19.3%±0.6%, and left AP: −19.2%±0.8%) had lower global CS (GCS) compared with controls (−23.1%±0.4%, all P<0.001). The septal AP group showed lower global LS (GLS) (−17.2%±0.5%), global RS (GRS) (30.1%±2.0%), and prolonged GLS-PSD (51.3±3.1 ms) than the left AP group and controls (P<0.05). The right AP group exhibited lower GLS (−17.5%±0.5%) than the left AP group (−19.6%±0.5%, P<0.05) and prolonged GLS-PSD (46.7±2.5 ms) compared with controls (31.6±1.1 ms, P<0.001). The left AP group showed GLS (−19.6%±0.5%), GRS (40.0%±2.6%), and GLS-PSD (40.1±2.3 ms) that were not significantly different from controls (all P>0.05). LV ejection fraction (LVEF) was lower in septal (59.2%±1.2%) and right AP groups (59.8%±1.0%) vs. controls (65.0%±0.3%; P<0.001). LVEF correlated negatively with GLS (r=−0.53, P<0.001) and with GLS-PSD (r=−0.41, P<0.001). Conclusions LV mechanical dysfunction in WPW syndrome varies by AP location. Septal and right APs lead to widespread strain impairment, dyssynchrony, and lower LVEF, whereas left APs mainly reduce CS. Reduced LVEF is closely associated with impaired LV mechanics and dyssynchrony.
Mingxia Li, Fen Chen, Jing Yao et al.· Quantitative Imaging in Medi...· 0 citations
A comprehensive AI system that provides accurate, immediate, and interpretable feedback on echocardiographic quality is successfully developed and clinically deployed, demonstrating strong potential to standardize image acquisition, enhance diagnostic confidence, and improve the efficiency of both clinical practice and sonographer training.
Zhongqing Shi, Hanlin Cheng, Zhanru Qi et al.· Journal of the American Soci...· 0 citations