An exact differentiation between vital and non-vital myocardial tissues of patients with a restricted leftventricular ejection fraction has a great relevance for diagnostics and therapy. Only vital myocard benefits from a coronary revascularisation. Due to the fact that approximately 70% of all coronary angiographies are performed with possible intervention avaibilities, it is of great interest to clarify the myocardial vitality during the diagnostic process.
The 2D strain analysis is an innovative echocardiographic method which enables precise statements about the deformation of the myocard and the deformation's speed. Our clinical partner showed within successful validation studies that the accuracy of the 2D strain analysis parameter for the myocardial vitality are comparable to MRI diagnostics.
We develop in this project a fusion of 2D strain analysis and X-ray based biplane coronary angiography. This combination enables the correct spatial correspondence between stenosed coronary arteries and the myocardial segments which they should support to achieve an intraprocedural vitality diagnosis. Using this approach, a decision about an intervention (PCI) could be made without incorporating delays due to MRI diagnostics.
Figure: Concept for the intraprocedural fusion of echocardiography and coronary angiography