Roman Kerekes*, Laboratory of Biocybernetics, Dept. of Pathophysiology, Charles University in Prague, Prague, Czech Republic Jiri Kofranek, Laboratory of Biocybernetics, Dept. of Pathophysiology, Charles University in Prague, Prague, Czech Republic Jaroslav Januska, Cardiac Center, Podlesi Hospital a.s., Trinec, Trinec, Czech Republic Track: Practice Presentation Topic: Mobile & Tablet Health Applications Presentation Type: Poster presentation Submission Type: Single Presentation Last modified: 2014-11-02

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BACKGROUND

Echocardiography is one of the non-invasive, widely available and basic methods to examine the heart. Current devices allow echocardiographic measurements and calculations of large amounts of hemodynamic and morphological parameters. To establish the diagnosis and assessment of severity of heart disease, it is needed to evaluate all available data.


OBJECTIVE

The goal of this study was to investigate the feasibility of CARDIO3®ECHO expert system for the diagnosis of heart diseases, using echocardiographic measurement data.


METHODS

We created a simulator for the measurement of echocardiographic parameters and implemented basic calculations of hemodynamic parameters (volume, flow, pressure or velocity). This system was tested on a database of findings of the CARDIO3® Comprehensive Atlas of Echocardiography. The measurement results are the basis for the text description, which is compiled from standard clinical keywords. The application enables adding other parameters required for the evaluation of echocardiographic findings, such as age, weight and height of the patient. The results and calculations are stored in the database to verify the accuracy of the measurement. The system highlights the possible discrepancy between the measured parameters and calculated values. The application includes stratification of measurement results and the severity of heart disease.


RESULTS


During testing on the CARDIO3® database consisting nowadays of 644 echocardiographic samples (112 various case reports), we revealed several inaccuracies in calculated clinical findings. For instance the left atrium short axis dimension measured from parasternal view (LA PSAX) indicated a normal (non-dilated) left atrium (LA) size whereas measurement of the left atrium volume from apical view resulted in moderate LA dilatation (due to the elongated shape).

Another example was the evaluation of severity of aortic valve stenosis. Aortic valve area (AVA) measured directly from the parasternal short-axis view (PSAX) mismatched the calculation of AVA using a continuity equation.
The system makes alerts if any controversy occurs in the assessment of valvular heart diseases, systolic or diastolic ventricular function, evaluation of pulmonary hypertension or hemodynamics in restrictive cardiomyopathy/constrictive pericarditis. The app is available on iPad devices. The authors of the cases and charts are comprised of clinical cardiologists and internal fellows.


CONCLUSIONS

Our study showed that simulator-based training in echocardiography could be very effective and if implemented in the echocardiography device may be helpful in clinical practice. In a routine clinical setting it enables quicker processing of the examination protocol and a prompt final recommendation for the management of the patient.