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Fully automated analysis of colonic manometry recordings.

The purpose of this study was to develop a computer program for fully automated analysis of all presently known motor patterns in human colonic motility recordings. Colonic pressure recordings obtained from 24 healthy volunteers were used. Algorithms were developed for the detection and numerical analysis of five types of pressure waves: antegrade, retrograde, simultaneous, high-amplitude and isolated pressure waves. Furthermore, periodical motor activity was quantified. Validation was performed by comparison with visual analysis by two experienced observers. Patterns recorded during day- and night-time were compared using multiple-factor analysis of variance with Bonferroni correction. Automated analysis correlated well with visual peak detection (r = 0.98, P <0.01) and detection of antegrade pressure waves (r = 0.98, P <0.01). Most motor patterns showed a diurnal variation. During the night, prevalences of antegrade (938 vs 455; P <0.05), retrograde (112 vs 81; P <0.05), high-amplitude (12.9 vs 1.3; P <0.05), isolated pressure waves (1114 vs 765; P <0.05), and periodic motor activity were decreased (7.33 vs 4.47%; P <0.05). However, when expressed as percentage of absolute numbers of pressure waves, prevalences remained constant. In conclusion, fully automated analysis of all hitherto described colonic motility patterns is feasible. During the night, overall wave prevalences markedly decreased, but the distribution over the various motor patterns was preserved.

Adult↗

Robotic selective sampling and total automation for anti-CMV screening.

The provision of anti-cytomegalovirus (CMV)-negative blood products causes the blood banking community considerable logistical problems. This is due firstly to the fact that only a select group of patients require anti-CMV-negative units, namely the immunocompromised. Secondly, the prevalence of CMV antibody in the blood donor population is high and, thirdly, the demand for anti-CMV-negative blood components continues to increase. To address this problem, a system of robotic selective sampling and total assay automation for anti-CMV screening has been developed. An in-house computer program generates a worklist from the donation database of samples requiring screening to meet clinical demand. Algorithms incorporated in the program ensure that the minimum number of samples possible are selected for provision of anti-CMV-negative products. This 'intelligent' selection of samples substantially reduces reagent cost. Robotic pipetting from the electronically derived worklist, masterplate to test plate robotic transfer and use of an automated assay processor maintains specific sample identification throughout. Results are read mechanically and transmitted directly to the main computer system. Robotic selective sampling and total assay automation produces an efficient, secure, auditable and completely traceable system for the provision of anti-CMV-negative units. The system produced a substantial reduction in labour costs with a 40% reduction in reagent usage. This system can be readily adapted for screening other markers on a selective basis.

Antibodies, Viral↗

The impact of including passive benefits in cost-effectiveness analysis: the case of automated external defibrillators on commercial aircraft.

OBJECTIVE: Traditional cost-utility analysis assumes that all benefits from health-related interventions are captured by the quality-adjusted life-years (QALYs) gained by the few individuals whose outcome is improved by the intervention. However, it is possible that many individuals who do not directly benefit from an intervention receive utility, and therefore QALYs, because of the passive benefit (aka sense of security) provided by the existence of the intervention. The objective of this study was to evaluate the impact that varying quantities of passive benefit have on the cost-effectiveness of airline defibrillator programs. METHODS: A decision analytic model with Markov processes was constructed to evaluate the cost-effectiveness of defibrillator deployment on domestic commercial passenger aircraft over 1 year. Airline passengers were assigned small incremental utility gains (.001-.01) during an estimated 3-hour flight to evaluate the impact of passive benefit on overall cost-effectiveness. RESULTS: In the base case analysis with no allowance for passive benefit, the cost-effectiveness of airline automated external defibrillator deployment was US dollars 34000 per QALY gained. If 1% of all passengers received utility gain of.01, the cost-effectiveness declined to US dollars 30000. Cost-effectiveness was enhanced when the quantity of passive benefit was raised or the percentage of individuals receiving passive benefit increased. CONCLUSIONS: Automated external defibrillator deployment on passenger aircraft is likely to be cost-effective. If a small percentage of airline passengers receive incremental utility gains from passive benefit of automated external defibrillator availability, the impact on overall cost-effectiveness may be substantial. Further research should attempt to clarify the magnitude and percentage of patients who receive passive benefit.

Aircraft↗

Regional blood center automation.

The operation of an automated regional blood center is outlined. The basic approaches used to achieve economical automation that is compatible with existing manual protocols are described. Finally, the role of centralized, automated blood typing is discussed in the context of the operations of The Greater New York Blood Program which involves a central Groupamatic blood typing facility serving four blood centers.

Blood Banks↗

The utility of platelet washing using an automated procedure for severe platelet allergic reactions.

Increased use of platelets in patients requiring chronic platelet support has increased platelet transfusion reactions. The authors reviewed more than 300 platelet transfusion reactions, evaluated an automated platelet washing technique, and studied the effectiveness of washing platelets to reduce reactions. Febrile reactions (66%) were most frequently reported, followed by moderate and severe allergic reactions (15%), and urticaria alone (19%). Washed platelets were prepared by an automated technique (IBM/COBE 2991). In vitro studies indicated no apparent adverse effects to the platelets due to the wash procedure, and in vivo studies demonstrated good platelet increments in 10 thrombocytopenic patients. Twenty-two patients with histories of platelet transfusion reactions received a total of 554 washed platelet transfusions. Washed platelets were not effective in reducing febrile transfusion reactions in 16 patients receiving 347 washed products. The efficacy of washed platelets in reducing transfusion reactions was demonstrated in six patients with histories of severe allergic reactions who received 207 washed products. Severe allergic reactions were completely alleviated in this group. In conclusion, automated platelet washing is simple and efficacious in preventing or reducing the severity of allergic reactions to platelet transfusions.

Adult↗

Collection of peripheral blood progenitor cells with an automated leukapheresis system.

BACKGROUND: Apheresis devices designed for the collection of mature blood elements are being used for the collection of peripheral blood progenitor cells (PBPCs). The collection of PBPCs differs from that of other cells in the rarity of the target cell and in the fact that donors may undergo several days of collection. A consequence of this process may be a depletion of blood cells such as platelets from the blood. The disposable set and operating software for an apheresis device (Spectra, COBE BCT) was modified by the manufacturer to automate the collection of PBPCs and reduce the collection of unwanted blood cells. STUDY DESIGN AND METHODS: A study was initiated to compare the collection of PBPCs with the new device, the AutoPBSC (version [V]6.0 with AutoPBSC tubing set), and that with the MNC (mononuclear cell) procedure (V4.7 with white cell tubing set), for patients and healthy donors. RESULTS: Patients whose blood was processed by either theV6.0 orV4.7 procedure achieved the target dose of 5 x 10(6) CD34+ cells per kg of patient weight in similar numbers of procedures, even though the calculated collection efficiency for CD34+ cells using the automated V6.0 procedure was significantly less than that with the V4.7 procedure for both allogeneic donors and patients donating PBPCs. The collection efficiency for platelets was lower with the V6.0 procedure, and components collected in this manner contained fewer platelets. Apheresis by the V6.0 procedure required 30 to 60 more minutes per procedure than apheresis by the V4.7 procedure. Review of engraftment kinetics after transplantation did not reveal any effect of the collection procedure on recipients of either allogeneic or autologous transplants. CONCLUSION: The collection efficiencies of the V6.0 procedure for both CD34+ cells and mature blood cells are lower than those of the V4.7 procedure. The lower collection efficiency for platelets results in a smaller drop in peripheral blood platelet count after the procedure. The automated features of the V6.0 procedure may simplify PBPC collection, but this procedure requires a longer apheresis.

Adult↗

Improved collection of mobilized CD34+ hematopoietic progenitor cells by a novel automated leukapheresis system.

BACKGROUND: For simplification of blood cell transplantation, an automated apheresis system that exploits a dual-stage channel device for mononuclear cell (MNC) collection (AutoPBSC, designed for the COBE Spectra) was studied. STUDY DESIGN AND METHODS: The automated default software (AutoPBSC-Default) and three software modifications of the harvest frequency during leukapheresis, referred to as AutoPBSC-1.25, AutoPBSC-1.75, and AutoPBSC-2.75, were evaluated in comparison with the semiautomated Version 4.7 (V4.7) apheresis system in 119 leukapheresis procedures performed in 90 cancer patients treated with chemotherapy plus granulocyte-colony-stimulating factor. CD34+ cell and platelet collection efficiency (CE); volume and cell composition of the leukapheresis components; and patient platelet and red cell (RBC) loss during leukapheresis were measured. RESULTS: The majority of collection measures evaluated with the AutoPBSC compared favorably to those obtained with the V4.7. CD34+ cell CE increased from 55 percent with V4.7 to 68 percent with the AutoPBSC-Default (p = 0.05). The AutoPBSC provided lower platelet contamination in the collected component (1.18 x 10(11) vs. 2.26 x 10(11) with the V4.7; p<0.001). The volume of the AutoPBSC-Default component was significantly lower (67 vs. 180 mL with the V4.7; p<0.001). The MNC purity of the AutoPBSC component was greater (52 vs. 28% with the V4.7; p<0.001), and the RBC contamination lower (AutoPBSC, 0.53 x 10(11) vs. 1.04 x 10(11) with the V4.7; p<0.001). Modifications of the AutoPBSC to increase the harvest frequency by 1.25-, 1.75-, and 2.75-fold resulted in increased CD34+ cell CE (77%, 75%, and 83%, respectively; p<0.001 in all cases), but also in reduced numbers of circulating platelets, higher platelet contamination of the component, and lower MNC purity than were seen with the AutoPBSC-Default. CONCLUSION: The AutoPBSC offers the following advantages over the V4.7 system: a) better CE of CD34+ cells; b) reduced collection of platelets; c) reduced contamination of the leukapheresis component with granulocytes, platelets, and RBCs; d) reduced component volume; and e) automation.

Adolescent↗

A novel, automated method of temperature cycling to produce cryoprecipitate.

BACKGROUND: Cryoprecipitate continues to find wide application in transfusion practice. Current AABB standards call for a minimum of 80 units (U) of factor VIII and 150 mg of fibrinogen per bag of cryoprecipitate. However, individual cryoprecipitates can vary greatly in content, with as many as 20 different factors known to affect the yield. STUDY DESIGN AND METHODS: Plasma was processed in a new, rapid, automated device (CryoSeal, Thermogenesis) with computer-controlled temperature cycling to produce cryoprecipitate. RESULTS: In repeat runs (n = 20), the automated procedure yielded a product containing 184 mg of fibrinogen and 158 U of factor VIII in 55 minutes. Additional studies using plasma pools to compare the quality of the machine-generated products to those of traditionally prepared cryoprecipitate showed comparative recoveries of 182 and 187 mg of fibrinogen and 172.1 and 129.7 U of factor VIII and no significant difference in the levels of plasminogen, protein C, or protein S. CONCLUSION: The new system offers an automated method of cryoprecipitate production in which the steps involved in temperature cycling are initiated sequentially, producing within 1 hour a preparation that is equivalent to standard cryoprecipitate.

Cryopreservation↗

Optimizing pretransfusion antibody detection and identification: a parallel, blinded comparison of tube PEG, solid-phase, and automated methods.

BACKGROUND: The ideal pretransfusion testing strategy identifies maximal significant antibodies at minimal cost. Objectives of this study were to compare the characteristics of three testing methods and determine their optimal incorporation into the following generic testing sequence: 1) screen, for antibodies 2) if results are positive, use primary identification method, 3) if results are inconclusive, use secondary identification method. STUDY DESIGN AND METHODS: A total of 2000 consecutive, unselected, coded specimens were tested with three screening methods-PEG IAT, manual and automated solid phase red cell adherence assay (SPRCA). Of 202 positive results, 187 were of sufficient volume and were tested with both PEG and manual SPRCA identification panels, yielding 82 with significant antibodies, plus one that was negative by both methods found on retrospective review of nonstudy results. Calculations were made on the 1985 volume-sufficient specimens, simulating the possible testing permutations. RESULTS: Manual SPRCA was the most sensitive antibody screen (67/83 = 81%) and the least specific (1840/1902 = 97%); automated SPRCA was the least sensitive (54/83 = 65%) and most specific (1883/1902 = 99%); and PEG was intermediate in both sensitivity (64/83 = 77%) and specificity (1860/1902 = 98%). Of the identification panels, manual SPRCA identified more antibodies than PEG (67 versus 66) but had more inconclusive results (41 versus 20). Of overall strategies, manual SPRCA screening with either sequence of identification methods identified the most antibodies (66). The combination of PEG screen, PEG identification, and manual SPRCA identification identified slightly fewer antibodies (63) but had the lowest reagent cost, total (reagent plus labor) cost, and cost per antibody identified. The sequence of automated SPRCA screening with manual SPRCA identification, and PEG identification had the lowest hands-on time. CONCLUSIONS: The most cost-effective pretransfusion strategy is PEG screen with PEG identification, plus manual SPRCA identification when PEG identification is inconclusive.

Antibodies↗

Efficacy and safety of a 7.5% icodextrin peritoneal dialysis solution in patients treated with automated peritoneal dialysis.

In a randomized, prospective, multicenter study, we compared the safety, efficacy, and metabolic effects of a 7.5% icodextrin solution (Extraneal) with a 2.27% glucose solution for long dwell exchanges in patients undergoing automated peritoneal dialysis. Thirty-nine stable patients on automated peritoneal dialysis were randomized to receive either icodextrin (n = 20) or glucose 2.27% solution (n = 19). The study included a 2-week baseline period followed by a 12-week icodextrin treatment phase and a 2-week follow-up period when switching back to glucose. The average net ultrafiltration during the long dwell period was 278 +/- 43 mL/d for the icodextrin group and -138 +/- 81 mL/d for the control group (P < 0.001). The higher ultrafiltration volume with icodextrin was associated with higher creatinine (2.59 +/- 0.09 mL/min versus 2.16 +/- 0.11 mL/min) and urea (2.67 +/- 0.09 mL/min versus 2.28 +/- 0.12 mL/min) peritoneal clearances for the long dwell (both P < 0.001). Ultrafiltration rate per mass of carbohydrate absorbed was +5.2 +/- 1.2 microL/min/g in the icodextrin group and -5.5 +/- 2.8 microL/min/g in the glucose group (P < 0.001). In the icodextrin group, there was a decrease in serum sodium and chloride compared with baseline (P < 0.01). Total dialysate sodium removal increased in the icodextrin group from 226.7 mEq to 269.6 mEq (week 12, P < 0.001). Serum alpha-amylase activity decreased from 103 U/L to 16 U/L (P < 0.001). The total icodextrin plasma levels reached a steady-state concentration of 6,187 +/- 399 mg/L after 1 week of treatment. Urine volume and residual renal function were not specifically affected by icodextrin compared with glucose. None of the laboratory changes resulted in any reported clinically meaningful side effect. Icodextrin produced increased, sustained ultrafiltration during the long dwell period, increasing (convective) peritoneal clearance and sodium removal in automated peritoneal dialysis patients.

Absorption↗

CT-guided transthoracic needle biopsy of pulmonary nodules smaller than 20 mm: results with an automated 20-gauge coaxial cutting needle.

AIMS: To evaluate the efficacy and the complication rate of CT-guided percutaneous lung biopsy of pulmonary nodules smaller than 20 mm in diameter using a 20-gauge coaxial automated biopsy device. MATERIAL AND METHODS: A prospective study was undertaken of 200 patients who underwent 202 consecutive biopsies of pulmonary nodules, performed with a single type of automated biopsy device. Sixty-seven biopsies of nodules smaller than 20 mm in diameter were performed in 66 patients (group A). One hundred and thirty-five biopsies of lesions of 20 mm or greater in size were performed in 134 patients (group B). Patient characteristics, lesion and procedure variables, the accuracy and complication rates were compared. RESULTS: In group A, the final diagnosis of the nodules was malignant in 47 and benign in 19 cases (prevalence of malignancy 71. 2%). In group B, there were 111 malignant and 21 benign diagnoses (prevalence of malignancy 82.2%). In group A, the sensitivity and specificity for a diagnosis of malignancy were 89.5 and 100%, respectively (positive predictive value 100%, negative predictive value 76%). A specific diagnosis of benignity was obtained in nine out of 19 (47%) biopsies. The pneumothorax rate was 15% (10 patients) of which two (3%) required drainage. CT signs thought to reflect alveolar haemorrhage were noted in 28 (43%) and haemoptysis occurred in five patients (5.9%). In group B, the sensitivity and specificity for a diagnosis of malignancy were 95.5% and 100%, respectively (positive predictive value 100%, negative predictive value 82.7%). A specific diagnosis of benignity was made in 14 cases (58.3%). Complications included pneumothoraces in 22 cases (16.2%) requiring drainage in one (0.7%). Presumed alveolar haemorrhage was recorded in 19 cases (14.1%) and haemoptysis occurred in seven (5. 2%). There were no significant differences between group A and group B, except for alveolar haemorrhage (P < 0.001). CONCLUSION: The accuracy and complication rate of percutaneous CT-guided biopsy of nodules smaller than 20 mm, performed using an automated 20-gauge coaxial biopsy device, are comparable to those for larger lesions.

Adult↗

[Studies with the fully automated EEG sleep analysis system QUISI].

To judge sleep reliably would be interesting not only for outpatient sleep diagnostics, but also in the inpatient sphere. A step in this direction is the easy-to-apply fully automated sleep-EEG-analysis system QUISI. Nine males patients with obstructive sleep apnoea syndrome were examined simultaneously by polysomnography and the QUISI system. A comparison of the sleep profiles evaluated by polysomnographic recordings using Rechtschaffen and Kales' rules with the automated classification using QUISI recording shows that the difference of the sleep parameters sleep period time (SPT), total sleep time (TST), REM, stage 1, stage 2, slow-wave sleep and the awake stage of maximum five patients ranged between +/- 10 minutes, respectively +/- 5 per cent. Only two of nine sleep profiles could be compared as far as the sequence of the sleep stages was concerned. According to our results it is important to edit the original data and to treat the fully automated sleep profile. We cannot recommend QUISI to establish sleep profiles for the obstructive sleep apnoea syndrome.

Adult↗

[Automated image analysis of lateral roentgen images of the spine using anatomic models].

PURPOSE: Development of a software for fully automated image analysis of lateral lumbar spine X-rays. MATERIAL AND METHOD: Using the concept of active shape models, we developed a software that produces a form model of the lumbar spine from lateral lumbar spine radiographs and runs an automated image segmentation. This model is able to detect lumbar vertebrae automatically after the filtering of digitized X-ray images. The model was trained with 20 lateral lumbar spine radiographs with no pathological findings before we evaluated the software with 30 further X-ray images which were sorted by image quality ranging from one (best) to three (worst). There were 10 images for each quality. RESULTS: Image recognition strongly depended on image quality. In group one 52 and in group two 51 out of 60 vertebral bodies including the sacrum were recognized, but in group three only 18 vertebral bodies were properly identified. CONCLUSION: Fully automated and reliable recognition of vertebral bodies from lateral spine radiographs using the concept of active shape models is possible. The precision of this technique is limited by the superposition of different structures. Further improvements are necessary. Therefore standardized image quality and enlargement of the training data set are required.

Humans↗

[Endothelial keratopathy in pseudoexfoliation syndrome: quantitative and qualitative morphometry using automated video image analysis].

UNLABELLED: This prospective study intended to quantify and classify morphological changes of the corneal endothelium in pseudoexfoliation syndrome (PSX) after having tested reproducibility and validity of a new automated technique for analysing corneal endothelium. PATIENTS AND METHODS: We used a contact specular microscope combined with a video camera (Tomey EM-1000) and a computer (IBM compatible PC, 486DX33) with suitable software (Tomey EM-1100, version 0.94). Video images of corneal endothelium (area: 0.312 mm2) are passed directly into the computer input by means of a frame grabber and are automatically processed. Missing or falsely recognized cell borders are corrected using the mouse. We examined 85 eyes with PSX and 33 healthy control eyes. At first, retest-stability and validity of the cell density measurements were assessed in the PSX-eyes. A qualitative analysis of the corneal endothelium followed. RESULTS: The cell density measurements showed a high retest-stability (reliability coefficient r = 0.974). The values of the automated method (2040 +/- 285 cells/mm2) and those of manual cell counting (2041 +/- 275 cells/mm2) did not differ significantly (p = 0.441). The mean difference was 3.1 +/- 2.4%. Comparing the 85 PSX-eyes (2052 +/- 264 cells/mm2) to the 33 control eyes (2372 +/- 276 cells/mm2), there was a significant reduction of cell density (p < 0.001). The cell density of the 69 PSX-eyes with glaucoma (2014 +/- 254 cells/mm2) was significantly lower than that of the 16 PSX-eyes without glaucoma (2214 +/- 251 cells/mm2) (p = 0.008). Eighty-five percent of the 85 PSX-eyes showed polymegalism, 77% pleomorphism; 68% had white deposits and 42% guttae. White deposits and guttae were significantly more frequent and more intensive in PSX-eyes than in control eyes. PSX-eyes with and those without glaucoma showed no significant differences concerning the four qualitative parameters. CONCLUSION: The automated method for analysing corneal endothelium quickly provides reproducible and valid results using the correction mode of the software. Semiquantitative analysis of qualitative parameters permits a more differentiated assessment of keratopathy in pseudoexfoliation syndrome than does mere consideration of endothelial cell density. Both evaluations are recommended to assess the risk of a diffuse endothelial decompensation before intraocular surgery.

Aged↗

[Possibilities for the use of manual and automated scanning procedures in ultrasonic mammography].

The limitations and advantages of the different ultrasonic breast-scanner (manual and automated) were described, likewise experiences with an automated waterpath scanner (Octoson). For breast cancer screening the automated scanner seems to be an acceptable concept, because it manifests the breast with an excellent anatomic view. In addition the mamma is in a stable position and the examination can be properly delegated. The manual examination can be used as an additional examination. Ultrasound scan can be correlated with the manual examination and a cyst can be punctured under ultrasonic control. Essential technological improvements are to be expected by both ultrasonic systems.

Adenofibroma↗

Rapid and accurate noninvasive assessment of global left ventricular systolic function using biplane advanced automated contour tracking method.

BACKGROUND: The advanced automated contour tracking (AACT) method has been newly developed for automated detection of the left ventricular endocardial boundary. Left ventricular ejection fraction (LVEF) may be estimated by applying the AACT method to 2 orthogonal planes of patients even when regional wall-motion abnormalities exist. The purpose of this study was to examine the reliability of the biplane AACT method in the measurement of LVEF in patients with suggested ischemic heart disease with use of quantitative gated single photon emission computed tomography (QGS) as a reference standard. METHODS: The study population consisted of 47 consecutive patients with suggested ischemic heart disease. All patients underwent 2-dimensional echocardiography and QGS. Biplane LVEF from apical 4- and 2-chamber views was measured offline by the AACT method using disk summation method. The accuracy of the AACT method for LVEF measurement was determined in comparison with QGS. RESULTS: In 41 (29 with and 12 without regional wall-motion abnormalities) of 47 patients (87%), automated tracing of the endocardial border was adequately achieved with the AACT method. LVEF measured by the AACT method correlated well with that measured by QGS (y = 0.97x +2.4, r = 0.91). The mean difference between AACT and QGS was 0.6 +/- 5.5% (mean +/- SD). The mean time required for analysis of 1 set of images during 1 cardiac cycle by the AACT method was much shorter than that required by manual tracing method (7 +/- 1 vs 37 +/- 4 seconds, P <.0001). CONCLUSION: The biplane AACT method provides accurate and quick measurement of LVEF in patients even with regional wall-motion abnormalities.

Adult↗

Assessment of ventricular filling volumes with an automated color Doppler method: validation in a pulsatile flow model.

OBJECTIVE: Determination of ventricular filling volumes with the use of Doppler echocardiographic measurements critically depends on the presence of a circular-shaped flow area and a flat velocity profile across it because evaluation of flow volume is usually based on echocardiographic measurements of its diameter and pulsed Doppler recordings within the center of this area. The approach may be limited at the mitral and tricuspid ring levels as a result of their noncircular shape and because nonflat velocity profiles are present. The purpose of this study was to examine in a pulsatile flow model simulating ventricular inflow conditions the accuracy of an automated method based on the analysis of color Doppler flow velocities for evaluation of flow volumes. MATERIALS AND METHODS: A recently-developed automated Doppler method that takes into account the velocity distribution across a region of interest was examined in a pulsatile flow model by using flows with waveforms characteristic for ventricular inflow through tubes with elliptically-shaped cross-sectional areas. Color Doppler imaging was performed against flow direction along the major and minor axes of the tubes with major diameters ranging between 3 and 5 cm and major-to-minor diameter ratios of 1.5 and 2.0. RESULTS: A close correlation was found between flow volumes measured by the Doppler technique for registrations along the minor or major axis of the ellipses and actual values (r = 0.99, standard error of the estimate = 0.44 to 1.98 mL), with a systematic underestimation or overestimation, respectively, depending on the diameter ratio. Averaging of the data derived from 2 orthogonal measurements by using the geometric mean value yielded an excellent agreement between Doppler data and actual flow volumes. CONCLUSION: This automated color Doppler method enables reliable determination of flow volumes in a pulsatile flow model simulating ventricular inflow conditions with the use of 2 orthogonal imaging views. The data indicate that the method may improve the noninvasive evaluation of ventricular filling volumes.

Echocardiography, Doppler, Color↗

Automated calculation of the Tei index from signal averaged left ventricular acoustic quantification wave forms.

The Tei index is a combined measurement of systolic and diastolic left ventricular (LV) performance and may be more useful for the diagnosis of global cardiac dysfunction than either systolic or diastolic measures alone. We sought to determine whether the Tei index could be accurately calculated from LV area waveforms generated with automated border detection. Twenty-four patients were studied in 3 groups: systolic dysfunction, diastolic dysfunction, and normal. The Tei index was calculated both from Doppler tracings and from analysis of LV area waveforms. Excellent agreement was found between Doppler-derived timing intervals and the Tei index with those obtained from averaged LV area waveforms. A significant difference was seen in the Tei index, computed with both Doppler and automated border detection techniques, between the normal group and those with LV systolic dysfunction and subjects with isolated diastolic dysfunction. This study validates the use of LV area waveforms for the automated calculation of the Tei index.

Acoustics↗