Automated coupled-contour and robust myocardium tracking in stress echocardiography

Dobutamine stress echocardiography is a commonly used imaging modality for the diagnosis of coronary artery disease and the detection of myocardial viability. The major limitations are that it is operator dependent and that the analysis is subjective and qualitative resulting in interobserver variability. It is also tedious and time consuming. Consequently, several quantitative approaches have been proposed, such as acoustic quantification and color kinesis but none of these has proved to be fully quantitative. In this manuscript we describe the development of a new, quantitative technique based on tracking of both endocardium and epicardium providing information of endocardial excursion and myocardial thickening, a crucial parameter of wall function evaluation. Preliminary data indicate that the method is practical and feasible, but clinical trials are required to prove whether it will improve the sensitivity and specificity of dobutamine stress echocardiography.

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