Tesi sul tema "Déformation cardiaque"
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Altman, Mikhail. "Déformation myocardique et remodelage cardiaque". Thesis, Paris Est, 2014. http://www.theses.fr/2014PEST0056.
Testo completoNot transmitted
Roux, Sébastien. "Modèles dynamiques en tomographie - Application à l'imagerie cardiaque". Phd thesis, Grenoble 1, 2004. http://tel.archives-ouvertes.fr/tel-00007803.
Testo completoDedobbeleer, Chantal. "Echocardiographie de déformation et fonction ventriculaire gauche". Doctoral thesis, Universite Libre de Bruxelles, 2014. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209331.
Testo completoA travers trois études, nous avons montré que l’analyse des indices de déformation permet d’objectiver des modifications de fonction ventriculaire gauche indétectables en échocardiographie conventionnelle dans des situations complexes à fraction d’éjection conservée, en dépit de l’augmentation modérée de la fréquence cardiaque qui leur est associée. Les situations que nous avons étudiées sont les suivantes :l’adaptation physiologique à l’hypoxie au niveau de la mer et en altitude, et les situations pathologiques que sont le syndrome de mal d’altitude chronique, et la cardiomyopathie associée à l’ataxie de Friedreich.
L’intégration de nos résultats et des informations disponibles dans la littérature permet de suggérer que l’utilisation de toutes les ressources offertes par l’échocardiographie de suivi des marqueurs acoustiques permet d’améliorer l’évaluation de la fonction cardiaque au-delà de la fraction d’éjection, en offrant une meilleure identification de situations pathologiques mais également une meilleure compréhension de situations physiologiques et pathologiques.
L’utilisation généralisée des indices de déformation pour l’évaluation de la fonction ventriculaire gauche en pratique clinique connaît néanmoins d’importantes limitations que nous abordons dans la discussion de ce travail. Au terme d’investigations complémentaires et de standardisation de la technique, l’incorporation d’un algorithme d’évaluation échographique de la fonction cardiaque à FEVG conservée combinant les paramètres échographiques conventionnels et les indices de déformation pourra être évalué de façon prospective pour sa translation en pratique clinique, avec pour finalité la proposition d’une définition mieux adaptée de l’insuffisance cardiaque à FEVG conservée.
Doctorat en Sciences médicales
info:eu-repo/semantics/nonPublished
Gueda, Moussa Moussa. "Biomarqueurs quantitatifs de la déformation myocardique multi-chambres et multidirectionnelle en imagerie IRM dynamique". Electronic Thesis or Diss., Sorbonne université, 2024. https://accesdistant.sorbonne-universite.fr/login?url=https://theses-intra.sorbonne-universite.fr/2024SORUS104.pdf.
Testo completoMyocardial strain quantified from echocardiography or from cine magnetic resonance imaging (MRI) using conventional image processing (speckle or feature tracking), is a powerful markerof myocardial damage, as it is modified earlier in the course of the disease as compared to global markers commonly used in clinical routine. Despite such performances, its systematic use in routine remains hampered by the complexity and the time-consuming nature of the manual initialization of the myocardial borders. Besides, clinical software is most often specific to the left ventricle, omitting the other chambers which are also targets of diseases but havinga much more complex geometry. In such a context, the main objectives of this thesis are: 1) to evaluate myocardial deformation through MRI feature tracking in all cardiac chambers while studying the effects of age on the estimated indices, 2) to take advantage of feature tracking derived contours in order to design new quantitative biomarkers of mechano-functional coupling between the atria and the ventricles in healthy aging, 3) to evaluate effect of data from different centers and manufacturers on these measurements and on strain measurements derived by feature tracking from cine MRI
Dahou, Abdellaziz. "Intérêt de la déformation longitudinale globale du ventricule gauche chez les patients atteints de sténose aortique à bas débit et bas gradient avec basse fraction d'éjection". Master's thesis, Université Laval, 2014. http://hdl.handle.net/20.500.11794/25322.
Testo completoAortic stenosis is the most common valvular heart disease in developed countries. Approximately, 5 to 10 % of patients with severe aortic stenosis have a low cardiac output with impaired left ventricular ejection fraction (LVEF). The presence of a low cardiac output can distort the assessment of the severity of the aortic stenosis and thus lead to non-adequate therapeutic decision. Two main challenges are posed by these patients. The first is to differentiate a truly severe AS from a pseudo-severe AS, i.e. a failing left ventricle unable to fully open valve slightly or moderately stenotic. This distinction is crucial because the aortic valve replacement will be beneficial only in the case of true-severe AS. The second challenge is to accurately quantify myocardial damage. To this effect, the contractile reserve is important to assess because patients who do not have contractile reserve have a high risk of operative mortality following AVR. Unfortunately, traditional parameters derived from rest or stress echocardiography that are used to assess the severity of AS and myocardial dysfunction are not adequate in low flow state. Therefore, quantification of the disease severity and the ensuing therapeutic management may not be appropriate in a large proportion of these patients. The main objective of this project is to determine the usefulness of left ventricular longitudinal deformation measured at rest and during stress echocardiography with dobutamine for risk stratification and its impact on prognosis and management of patients with low-gradient aortic stenosis with impaired LVEF. Our hypothesis is as follows: The left ventricular global longitudinal strain is superior to the LVEF to predict mortality in patients having LF-LG AS with low EF included in the TOPAS study.
Lim, Pascal. "Etude de la mécanique ventriculaire en échographie : modélisation de l'asynchronisme mécanique". Phd thesis, Université Paris-Est, 2010. http://tel.archives-ouvertes.fr/tel-00660675.
Testo completoLamy, Jérôme. "Développement et validation de biomarqueurs quantitatifs d'imagerie cardiaque : association entre structure et fonction myocardique". Thesis, Sorbonne université, 2018. http://www.theses.fr/2018SORUS045/document.
Testo completoCardiovascular diseases, which are still one of the leading causes of death worldwide, are the result of interdependent alterations of the heart structure and function coupled with the aggravating effects of metabolic diseases, aging and lifestyle. In this context, the goal of my thesis is to design and validate new, robust and fast cardiac imaging quantitative biomarkers to characterize myocardial function and structure as well as their relationships. A first work was focused on the development of a method to evaluate cardiac function, specifically myocardial deformation kinetics on all cardiac chambers from standard cine MRI images. The designed method was reproducible and its diagnostic ability was superior to conventional clinical indices. It was also able to detect subclinical age-related heart alterations. The aims of the second study were to develop a method for atrial fat quantification, based on CT images, and to evaluate it on a cohort of healthy subjects and patients with atrial fibrillation. Finally, the interaction between structural and functional myocardial indices was studied through the first in vivo validation in the MRI literature of cardiac deformation function, evaluated using our method, against histological quantification of the “fibro-fatty” tissue substrate
Lamy, Jérôme. "Développement et validation de biomarqueurs quantitatifs d'imagerie cardiaque : association entre structure et fonction myocardique". Electronic Thesis or Diss., Sorbonne université, 2018. https://accesdistant.sorbonne-universite.fr/login?url=https://theses-intra.sorbonne-universite.fr/2018SORUS045.pdf.
Testo completoCardiovascular diseases, which are still one of the leading causes of death worldwide, are the result of interdependent alterations of the heart structure and function coupled with the aggravating effects of metabolic diseases, aging and lifestyle. In this context, the goal of my thesis is to design and validate new, robust and fast cardiac imaging quantitative biomarkers to characterize myocardial function and structure as well as their relationships. A first work was focused on the development of a method to evaluate cardiac function, specifically myocardial deformation kinetics on all cardiac chambers from standard cine MRI images. The designed method was reproducible and its diagnostic ability was superior to conventional clinical indices. It was also able to detect subclinical age-related heart alterations. The aims of the second study were to develop a method for atrial fat quantification, based on CT images, and to evaluate it on a cohort of healthy subjects and patients with atrial fibrillation. Finally, the interaction between structural and functional myocardial indices was studied through the first in vivo validation in the MRI literature of cardiac deformation function, evaluated using our method, against histological quantification of the “fibro-fatty” tissue substrate
Zhou, Yitian. "Quantification du mouvement et de la déformation cardiaques à partir d'IRM marquée tridimensionnelle sur des données acquises par des imageurs Philips". Thesis, Lyon, 2017. http://www.theses.fr/2017LYSEI058/document.
Testo completoCardiovascular disease is one of the major causes of death worldwide. A number of heart diseases can be diagnosed through the analysis of cardiac images after quantifying shape and function. However, the application of these deformation quantification algorithms in clinical routine is somewhat held back by the lack of a solid validation. In this thesis, we mainly introduce a fast 3D tagged MR quantification algorithm, as well as a novel pipeline for generating synthetic cardiac US and MR image sequences for validation purposes. The main contributions are described below. First, we proposed a novel 3D extension of the well-known harmonic phase tracking method. The point-wise phase-based optical flow tracking was combined with an anatomical regularization model in order to estimate anatomically coherent myocardial motions. In particular, special efforts were made to ensure a reasonable radial strain estimation by enforcing myocardial incompressibility through the divergence theorem. The proposed HarpAR algorithm was evaluated on both healthy volunteers and patients having different levels of ischemia. On volunteer data, the tracking accuracy was found to be as accurate as the best candidates of a recent benchmark. On patient data, strain dispersion was shown to correlate with the extent of transmural fibrosis. Besides, the ischemic segments were distinguished from healthy ones from the strain curves. Second, we proposed a simulation pipeline for generating realistic synthetic cardiac US, cine and tagged MR sequences from the same virtual subject. Template sequences, a state-of-the-art electro-mechanical (E/M) model and physical simulators were combined in a unified framework for generating image data. In total, we simulated 18 virtual patients (3 healthy, 3 dyssynchrony and 12 ischemia), each with synthetic sequences of 3D cine MR, US and tagged MR. The synthetic images were assessed both qualitatively and quantitatively. They showed realistic image textures similar to real acquisitions. Besides, both the ejection fraction and regional strain values are in agreement with reference values published in the literature. Finally, we showed a preliminary benchmarking study using the synthetic database. We performed a comparison between gHarpAR and another tracking algorithm SparseDemons using the virtual patients. The results showed that SparseDemons outperformed gHarpAR in processing cine MR and US images. Regarding tagged MR, both methods obtained similar accuracies on motion and two strain components (circumferential and longitudinal). However, gHarpAR quantified radial strains more accurately, thanks to the myocardial incompressibility constraint. We conclude that motion quantification solutions can be improved by designing them according to the image characteristics of the modality and that a solid evaluation framework can be a key asset in comparing different algorithmic options
Bernard, Anne. "Prédiction de la réponse à la resynchronisation biventriculaire : au delà des asynchronismes". Thesis, Rennes 1, 2014. http://www.theses.fr/2014REN1B017/document.
Testo completoCardiac resynchronization therapy is a well-validated therapeutic in heart failure patients. However with a non-response rate of 30%, many approaches have been developed to optimize the selection of patients, especially the analysis of mechanical dyssynchrony in echocardiography. This work appears in the extension of these echocardiographic work by studying response to resynchronization beyond dyssynchrony
Betancur, Acevedo Julian Andrés. "Intégration d'images multimodales pour la caractérisation de cardiomyopathies hypertrophiques et d'asynchronismes cardiaques". Thesis, Rennes 1, 2014. http://www.theses.fr/2014REN1S089/document.
Testo completoThis work concerns cardiac characterization, a major methodological and clinical issue, both to improve disease diagnostic and to optimize its treatment. Multisensor registration and fusion methods are proposed to bring into a common referential data from cardiac magnetic resonance (CMRI), dynamic cardiac X-ray computed tomography (CT), speckle tracking echocardiography (STE) and electro-anatomical mappings of the inner left ventricular chamber (EAM). These data is used to describe the heart by its anatomy, electrical and mechanical function, and the state of the myocardial tissue. The methods proposed to register the multimodal datasets rely on two main processes: temporal registration and spatial registration. The temporal dimensions of input data (images) are warped with an adaptive dynamic time warping (ADTW) method. This method allowed to handle the nonlinear temporal relationship between the different acquisitions. Concerning the spatial registration, iconic methods were developed, on the one hand, to correct for motion artifacts in cine acquisition, to register cine-CMRI and late gadolinium CMRI (LGE-CMRI), and to register cine-CMRI with dynamic CT. On the other hand, a contour-based method developed in a previous work was enhanced to account for multiview STE acquisitions. These methods were evaluated on real data in terms of the best metrics to use and of the accuracy of the iconic methods, and to assess the STE to cine-CMRI registration. The fusion of these multisensor data enabled to get insights about the diseased heart in the context of hypertrophic cardiomyopathy (HCM) and cardiac asynchronism. For HCM, we aimed to improve the understanding of STE by fusing fibrosis from LGE-CMRI with strain from multiview 2D STE. This analysis allowed to assess the significance of regional STE strain as a surrogate of the presence of regional myocardial fibrosis. Concerning cardiac asynchronism, we aimed to describe the intra-segment electro-mechanical coupling of the left ventricle using fused data from STE, EAM, CT and, if relevant, from LGE-CMRI. This feasibility study provided new elements to select the optimal sites for LV stimulation
Chenoune, Yasmina. "Estimation des déformations myocardiques par analyse d'images". Thesis, Paris Est, 2008. http://www.theses.fr/2008PEST0014/document.
Testo completoThe work presented in this thesis is related to the cardiac images processing and the cardiac contractile function study, for a better comprehension of cardiac physiopathology and diagnosis. We implemented a method for the segmentation of the endocardial walls on standard MRI without tags. We used an approach based on the level set method, with a region-based formulation which gives satisfactory results on healthy and pathological cases. We proposed a practical method for the quantification of the segmental deformations in order to characterize the myocardial contractility. The method was clinically validated by the assesment of doctors and by comparison with the HARP method on tagget MRI. To improve the measurements precision, we proposed an iconic MRI/CT multimodal registration algorithm, using the maximization of the mutual information. We applied it to the localization of short-axis slices in CT volumes with good results. This work has as prospect its application to obtain high spatial and temporal resolutions CT sequences
Farah, Ahcène. "Contribution à la modélisation mathématique de la biomécanique de la pompe cardiaque : application à l'analyse des déformations pathologiques du ventricule gauche". Vandoeuvre-les-Nancy, INPL, 1989. http://www.theses.fr/1989NAN10405.
Testo completoMenini, Anne. "Mise en oeuvre d'un système de reconstruction adaptif pour l'IRM 3D des organes en mouvement". Thesis, Université de Lorraine, 2013. http://www.theses.fr/2013LORR0289/document.
Testo completoMagnetic Resonance Imaging (MRI) has two main features. The first one, its ability to manipulate contrast, is a major advantage compared to the other imaging modalities. It allows to access complementary information for a better detectability and a diagnostic more accurate. This is especially useful for myocardium pathologies. The second feature of MRI is also one of its main drawbacks: the acquisition process is slow. Therefore, patient motion is a significant obstacle because it disturbs the acquisition process, which leads to artifacts in the reconstructed image. Cardiac and thoracic imaging are particularly sensitive to this motion issue. The aim of this thesis is to develop a new motion correction method that can be integrated in a multi-contrast workflow. In a first phase, we studied apart the motion correction problem. To do so, we focused more particularly on the GRICS method which was already developed in the IADI laboratory. This method allows the joint reconstruction of an image free from artifact and a non-rigid motion model that describes the displacements occurring during the acquisition. The first major contribution of this thesis is an improvement of the GRICS method consisting mainly in adapting it to the 3D imaging. This was achieved with a new adaptive regularization method that perfectly suits the inverse problem posed in GRICS. The second major contribution of this thesis consists in the simultaneous management of the motion correction on multiple acquisitions with different contrasts. To do so, the MRI examination is considered as a whole. Thus we make the most of information shared between the different contrasts. All these methods have been applied and validated by simulations, tests on phantom, on healthy volunteers and on patients as part of clinical studies. We aimed more particularly at cardiac MR. Finally the developed methods improve the acquisition and reconstruction workflow in the framework of a real clinical routine
Tuyisenge, Viateur. "Coopération entre segmentation et mouvement pour l'estimation conjointe des déplacements pariétaux et des déformations myocardiaques". Thesis, Clermont-Ferrand 1, 2014. http://www.theses.fr/2014CLF1MM22/document.
Testo completoThe work done in this thesis is related to the project 3DStrain the overall objective of which is to develop a generic framework for the parietal and regional tracking of the left ventricle and to adapt it the 3D + t cardiac imaging modalities used in clinical routine (3D ultrasound, SPECT, cine MRI). We worked on the parietal motion and myocardial deformation. We made the state-of-the-art on motion estimation approaches in general and on methods applied to imaging modalities in clinical practice to quantify myocardial deformation taking into account their specificities and limitations. We focused on tracking methods that optimize the similarity between the intensities between consecutive images of a sequence to estimate the spatial velocity field. They are based on the assumption of the invariance of image gray level (or optical flow) and regularization terms are used to solve the aperture problem. We proposed a regularization term well suited to physical and physiological properties of myocardial motion. The advantage of the proposed approach relies on its flexibility to estimate the dense field of myocardial motion on image sequences over the cardiac cycle. Motion is estimated while preserving myocardial wall discontinuities. However, the data similarity term used in our method is based only on the intensity of the image. It properly estimates the displacement field especially in the radial direction as the movement of circumferential twist is hardly visible on cine MRI in short axis view, the data we used for performing the experiments. To make the estimation more robust, we proposed a dynamic evolution model for the cardiac contraction and relaxation to introduce the temporal constraint ofthe dynamics of the heart. This model helps to estimate not only the dense field of myocardial displacement, but also other parameters of myocardial contractility (the contraction phase and asymmetry between systole and diastole) in variational data assimilation formalism. Automatic estimation of deformation and myocardial contractibility (the strain, phase and asymmetry) was validated against the cardiological and radiological expertise (Dr Elisabeth Coupez and Dr Lucie Cassagnes, CHU Clermont-Ferrand) through semi-quantitative scores of contraction called Wall Motion Score (WMS) and Wall Thickening Index (WTI). The proposed method provides promising results for both motion estimation results and the diagnosis indices for evaluation of myocardial dyskinesia. In order to gain in robustness and accuracy, it is necessary to perform the measurement of strain and indices of myocardial contraction precisely inside endocardial and epicardial walls. Therefore, we conducted a collaborative work with Kevin Bianchi, another PhD student on the project 3DStrain and we proposed a method of coupling of myocardial segmentation by deformable models and estimation of myocardial motion in a variational data assimilation framework
Randrianarisolo, Solofohery. "Estimation des déformations du ventricule gauche sur des séquences ciné-IRM non-marquées". Phd thesis, Université Paris-Est, 2009. http://tel.archives-ouvertes.fr/tel-00473769.
Testo completoMenini, Anne. "Mise en oeuvre d'un système de reconstruction adaptif pour l'IRM 3D des organes en mouvement". Electronic Thesis or Diss., Université de Lorraine, 2013. http://www.theses.fr/2013LORR0289.
Testo completoMagnetic Resonance Imaging (MRI) has two main features. The first one, its ability to manipulate contrast, is a major advantage compared to the other imaging modalities. It allows to access complementary information for a better detectability and a diagnostic more accurate. This is especially useful for myocardium pathologies. The second feature of MRI is also one of its main drawbacks: the acquisition process is slow. Therefore, patient motion is a significant obstacle because it disturbs the acquisition process, which leads to artifacts in the reconstructed image. Cardiac and thoracic imaging are particularly sensitive to this motion issue. The aim of this thesis is to develop a new motion correction method that can be integrated in a multi-contrast workflow. In a first phase, we studied apart the motion correction problem. To do so, we focused more particularly on the GRICS method which was already developed in the IADI laboratory. This method allows the joint reconstruction of an image free from artifact and a non-rigid motion model that describes the displacements occurring during the acquisition. The first major contribution of this thesis is an improvement of the GRICS method consisting mainly in adapting it to the 3D imaging. This was achieved with a new adaptive regularization method that perfectly suits the inverse problem posed in GRICS. The second major contribution of this thesis consists in the simultaneous management of the motion correction on multiple acquisitions with different contrasts. To do so, the MRI examination is considered as a whole. Thus we make the most of information shared between the different contrasts. All these methods have been applied and validated by simulations, tests on phantom, on healthy volunteers and on patients as part of clinical studies. We aimed more particularly at cardiac MR. Finally the developed methods improve the acquisition and reconstruction workflow in the framework of a real clinical routine
Jia, Shuman. "Statistiques de forme, de structure et de déformation à l'échelle d'une population pour l'étude de la fibrillation auriculaire". Thesis, Université Côte d'Azur (ComUE), 2019. http://theses.univ-cotedazur.fr/2019AZUR4105.
Testo completoAtrial fibrillation (AF) is the most common cardiac arrhythmia, characterized by chaotic electrical activation and unsynchronized contraction of the atria. This epidemic and its life-threatening complications and fast progression call for diagnosis and effective treatment as early as possible. Catheter ablation, an invasive procedure that establishes lesions to block the trigger points of AF and creates a barrier to the propagation of the arrhythmia, is an effective treatment for patients refractory to anti-arrhythmic drugs. However, the success rate of the first-time ablation may range from 30% to 75%, such that multiple ablation procedures may be recommended, and atrial mechanical function may be adversely affected. With evolving imaging and digital technologies, the objective of the study is to understand the underlying physiology of AF better and to provide tools to assist clinical decision-making. We analyze the correlations between recurrent arrhythmia and patient characteristics before ablation, including the left atrial shape extracted from computed tomography images. Non-invasive extraction of the anatomical structures of the heart is a crucial prerequisite. We first developed semi-automatic methods to segment the left atrium and the left atrial wall from images. Next, we achieved good segmentation results with a neural network model. Then, we studied markers of shape related to both global and local remodeling, and the quantification of adipose tissue, deploying diffeomorphometry and statistical analysis tools. Finally, we extended the work to the statistical analysis of temporal deformation. We proposed a symmetric reformulation of the pole ladder, which improves the numerical consistency and stability
Bessière, Francis. "Amélioration des techniques d’ablation pour le traitement des arythmies cardiaques : nouvelles modalités diagnostiques et thérapeutiques par ultrasons". Thesis, Lyon, 2019. http://www.theses.fr/2019LYSE1225/document.
Testo completoAt the crossroads of medicine and physics, this work aimed to provide innovative diagnostic and therapeutic tools based on ultrasound, in the field of cardiac electrophysiology. A system capable of delivering HIFU into the heart by a transesophageal route using ultrasound (US) imaging guidance was developed and tested in vivo in six male pigs. HIFU exposures were performed on atria and ventricles. At the time of autopsy, visual inspection identified thermal lesions in the targeted areas in three of the animals. These lesions were confirmed by histologic analysis (mean size: 5.5 mm2 x 11mm2). No esophageal thermal injury was observed. One animal presented with bradycardia due to an atrio-ventricular block, which provides real-time confirmation of an interaction between HIFU and the electrical circuits of the heart. There was still a lack of accuracy, mainly related to cardiac motion, and to anatomical structures in between the targets and the transducer. It was mainly related to the in vivo model and its anatomy, far from the human’s. The search for a better model led to conclusive imaging tests on baboons. Additional experiments were conduced in order to improve the mapping of ventricular arrhythmias and the monitoring of lesion formation during ablation. First, experiments were conducted on left ventricles of four isolated working mode swine hearts. The protocol aimed at demonstrating that different patterns of mechanical activation could be observed whether the ventricle was in sinus rhythm, paced from the epicardium, or from the endocardium. Electromechanical wave imaging (EWI) acquisitions were recorded on the anterior, lateral, and posterior segments of the left ventricle. Loop records were blindly assigned to two readers. EWI sequences interpretations were correct in 89% of cases. The overall agreement rate between the two readers was 83%. When in a paced ventricle, the origin of the wave front was focal and originating from the endocardium or the epicardium. In sinus rhythm, wave front was global and activated within the entire endocardium towards the epicardium at a speed of 1.7±0.28 m.s-1. Wave front speeds were respectively measured when the endocardium or the epicardium were paced at a speed of 1.1 ± 0.35 m.s-1 vs 1.3±0.34 m.s-1 (p=NS). Lastly, we investigated the feasibility of a dual therapy and imaging approach with the same transoesophageal device. We demonstrated on ex-vivo samples that transoesophageal shear wave imaging (SWE) can map the extent of the HIFU lesions. HIFU ablation was performed with the transoesophageal probe on ex-vivo chicken breast samples (n=3), then atrium (left, n=2) and ventricle (left n=1, right n=1) of swine heart tissues. SWE provided stiffness maps of the tissues before and after ablation. Areas of the lesions were obtained by tissue color change with gross pathology and compared to SWE. Shear modulus of the ablated zones increased from 4.8±1.1 kPa to 20.5+/-10.0 kPa (ratio 5.0±3.2) in the chicken breast, from 12.2±4.3 kPa to 30.3±10.3 (ratio 3.2±2.0) in the atria and from 21.2±3.3kPa to 73.8±13.9kPa (ratio 3.7±1.2) in the ventricles. On gross pathology, the size of the lesions ranged from 0.1 to 1.5cm2 in the imaging plane area and morphometric characteristics were fitting with elasticity-estimated depths and widths of the lesions
Bessière, Francis. "Amélioration des techniques d’ablation pour le traitement des arythmies cardiaques : nouvelles modalités diagnostiques et thérapeutiques par ultrasons". Electronic Thesis or Diss., Lyon, 2019. http://www.theses.fr/2019LYSE1225.
Testo completoAt the crossroads of medicine and physics, this work aimed to provide innovative diagnostic and therapeutic tools based on ultrasound, in the field of cardiac electrophysiology. A system capable of delivering HIFU into the heart by a transesophageal route using ultrasound (US) imaging guidance was developed and tested in vivo in six male pigs. HIFU exposures were performed on atria and ventricles. At the time of autopsy, visual inspection identified thermal lesions in the targeted areas in three of the animals. These lesions were confirmed by histologic analysis (mean size: 5.5 mm2 x 11mm2). No esophageal thermal injury was observed. One animal presented with bradycardia due to an atrio-ventricular block, which provides real-time confirmation of an interaction between HIFU and the electrical circuits of the heart. There was still a lack of accuracy, mainly related to cardiac motion, and to anatomical structures in between the targets and the transducer. It was mainly related to the in vivo model and its anatomy, far from the human’s. The search for a better model led to conclusive imaging tests on baboons. Additional experiments were conduced in order to improve the mapping of ventricular arrhythmias and the monitoring of lesion formation during ablation. First, experiments were conducted on left ventricles of four isolated working mode swine hearts. The protocol aimed at demonstrating that different patterns of mechanical activation could be observed whether the ventricle was in sinus rhythm, paced from the epicardium, or from the endocardium. Electromechanical wave imaging (EWI) acquisitions were recorded on the anterior, lateral, and posterior segments of the left ventricle. Loop records were blindly assigned to two readers. EWI sequences interpretations were correct in 89% of cases. The overall agreement rate between the two readers was 83%. When in a paced ventricle, the origin of the wave front was focal and originating from the endocardium or the epicardium. In sinus rhythm, wave front was global and activated within the entire endocardium towards the epicardium at a speed of 1.7±0.28 m.s-1. Wave front speeds were respectively measured when the endocardium or the epicardium were paced at a speed of 1.1 ± 0.35 m.s-1 vs 1.3±0.34 m.s-1 (p=NS). Lastly, we investigated the feasibility of a dual therapy and imaging approach with the same transoesophageal device. We demonstrated on ex-vivo samples that transoesophageal shear wave imaging (SWE) can map the extent of the HIFU lesions. HIFU ablation was performed with the transoesophageal probe on ex-vivo chicken breast samples (n=3), then atrium (left, n=2) and ventricle (left n=1, right n=1) of swine heart tissues. SWE provided stiffness maps of the tissues before and after ablation. Areas of the lesions were obtained by tissue color change with gross pathology and compared to SWE. Shear modulus of the ablated zones increased from 4.8±1.1 kPa to 20.5+/-10.0 kPa (ratio 5.0±3.2) in the chicken breast, from 12.2±4.3 kPa to 30.3±10.3 (ratio 3.2±2.0) in the atria and from 21.2±3.3kPa to 73.8±13.9kPa (ratio 3.7±1.2) in the ventricles. On gross pathology, the size of the lesions ranged from 0.1 to 1.5cm2 in the imaging plane area and morphometric characteristics were fitting with elasticity-estimated depths and widths of the lesions
Li, Zhiqun. "Contribution à l'étude et à la réalisation de systèmes de télémesures biomédicales : application à la télésurveillance de l'activité cardiaque de plusieurs sujets, et à la télémesure des déformations mécaniques d'implants orthopédiques". Bordeaux 1, 1996. http://www.theses.fr/1996BOR10562.
Testo completoAlleau, Thibaut. "Development of a numerical platform to model the mitral valve". Thesis, Compiègne, 2021. http://www.theses.fr/2021COMP2649.
Testo completoMitral insufficiency is the first valvular disease worldwide, with a 2% prevalence. When open-heartsurgery is impossible for the patient, surgeons use percutaneous devices to help the mitral leaflets coapt. However, the only device currently available is based on the edge-to-edge mitral valve repair technique. This type of implant is not adapted for patients suffering from functional mitral insufficiency, where the ventricle is responsible for the lack of coaptation of the leaflets. This thesis aims to provide a numerical platform to help the development of a mitral valve implant adapted for those patients. Several mitral valve geometries were created from a parametric model using anatomical measurements. Finite element simulations of the mitral valve were performed using ADINA to determine the valve closure under constant pressure. Several material models were developed in large strain and large deformation to model the valve closure accurately. Pathological behaviour such as annulus dilatation and chordae rupture were modelled, and several methods were tested to implement medical devices. Fluid-structure interaction of a 2D mitral valve was obtained using an ALE description and a monolithic coupling approach. Both the systole and the diastole were reproduced and studied, and the hermetic seal of the valve was detailed. The numerical platform developed is suited to model mitral valve function and can be used to help the development of mitral implants. In addition, the parametric geometry model and the anisotropic material model will be useful to depict with realism the valve function. A 3D fluid-structure interaction of the mitral valve could be developed