Improving an Echo-based 3D-Hemodynamic Simulation Software— New Results Determining the Accuracy of Simulated Qp:Qs in ASD Patients

Background: 2D transthoracic echocardiography (TTE) remains the most important and cost-effective method in the diagnosis and treatment planning of patients with congenital heart defects (CHD). The development and integration of software applications is an integral part of current research and clinical practice in cardiology. We developed unique software for 3D visualization and hemodynamic calculations based on 2D TTE data, to enable learning and training for health care professionals and patient education. The morphology and topography of atrial septal defects (ASD) and the shunt calculation were the focus of this study as a base for further development of the 3D simulations for CHDs.

Methods: A single-center retrospective study was conducted. Patients with ASD, planned for interventional or surgical ASD closure at our institution were included. Qp:Qs was calculated using echocardiography by measuring left and right ventricular outflow tract diameters and the left and right subvalvular velocity time integral. Additional parameters for chamber quantification were measured according to the current ASE guidelines. A 3D hemodynamic heart model was created for every patient including the simulation of the individual shunt volume. Both methods were then compared using Spearman’s correlation coefficient.

Results: We included 74 patients with a mean age of 13 years (1.2–70 years) and a mean weight of 33.5 kg (7–100 kg). The mean deviation of the software calculation versus the estimation in the echo was −2% (SD ± 31.3%). Both methods showed a significant correlation between each other (p-value: <0.001).

Conclusion: The transfer of the 2D echocardiographic data and the creation of a 3D-simulated model show an excellent visualization and confirm the possibility of the application. The verification of the accuracy of the hemodynamic calculation of the shunt volume showed a statistically significant correlation between the conventional echo method and the calculation of the AI-based developed simulation software. The results allow further development of 3D hemodynamic models for different groups of CHDs. To improve and validate the accuracy of this software, a prospective comparative analysis of Qp:Qs calculated by software and measured during heart catheter is already in progress.

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Artikel online veröffentlicht:
11. Februar 2025