AbstractCardiovascular diseases a ect 25% of the world's population. While treatment of myocardial infarction and heart failure has advanced significantly over the past 30 years, with low mortality rates, questions remain regarding the pathophysiology of the progression to heart failure following myocardial infarction. Left ventricular strains have been identified as providing diagnostic and prognostic information. Differing strain metrics arise from different imaging modalities and also from a lack of standardisation of strain definition, hindering comparison and also adoption.
This thesis proposed a regional, layer-specific, circumferential left ventricular strain that is simple and robust to calculate. The reproducibility of this strain metric was demonstrated across different users and software packages and compared favourably to that of standard clinical metrics such as global strains and ejection fraction. Analysis of serial data from a physiologically representative porcine model of myocardial infarction demonstrated that the method was able to locate regions of infarcted myocardium. The results suggested that this strain metric could provide supplementary information to standard clinical measurements.
The method was then applied to a large human cohort from the UK Biobank. The results suggested that there are differences in regional strain and global function between healthy males and females. Differences in multiple functional metrics between healthy males and those suffering from cardiovascular disease were also observed. These results indicated that the regional strain metric created in this thesis has the potential to be useful for assessing human cardiac function and disease state but requires validation by a targeted clinical study.
|Date of Award||1 Nov 2021|
|Supervisor||Andrew Cookson (Supervisor), Katharine Fraser (Supervisor) & Richie Gill (Supervisor)|