All patients had a transthoracic echocardiography performed at time of study inclusion using a 2.5-MHz transducer on a commercially available ultrasound system (VIVID E95, GE Healthcare, Milwaukee, WI, USA). The echocardiograms were analyzed using EchoPAC software (GE Healthcare, Milwaukee, WI, USA). Analyses included estimation of left ventricular ejection fraction (LVEF) and left ventricular (LV) volumes (11 (link)).
Echopac software
Manufactured by GE Healthcare
Sourced in United States, Norway
EchoPAC is a software application developed by GE Healthcare that is designed to analyze and interpret echocardiographic data. The software provides tools for visualizing, measuring, and quantifying cardiac structures and functions from echocardiographic images and data.
Automatically generated - may contain errors
Lab products found in correlation
Vivid e9, by GE Healthcare (9 mentions)
Vivid e95, by GE Healthcare (5 mentions)
Vivid 1, by GE Healthcare (4 mentions)
Vivid 7, by GE Healthcare (4 mentions)
Vivid 7 ultrasound machine, by GE Healthcare (2 mentions)
12s rodent probe, by GE Healthcare (2 mentions)
Vivid e95 version 203 instrument, by GE Healthcare (2 mentions)
Ge 10s rs, by GE Healthcare (2 mentions)
Vivid 9, by GE Healthcare (2 mentions)
M5s phased array probe, by GE Healthcare (2 mentions)
Vivid 1 machine, by GE Healthcare (1 mentions)
Vivid e9 system, by GE Healthcare (1 mentions)
Software, by Tomtec (1 mentions)
Vivid e9 ultrasound system, by GE Healthcare (1 mentions)
Vivid 7 ultrasound instrument, by GE Healthcare (1 mentions)
Vevo 2100 ultrasound imaging system, by Fujifilm (1 mentions)
I13l transducer, by GE Healthcare (1 mentions)
Ge vivid e9, by GE Healthcare (1 mentions)
Ge vivid 7, by GE Healthcare (1 mentions)
Vivid 7 pro, by GE Healthcare (1 mentions)
72 protocols using echopac software
1
Echocardiographic Assessment of LV Function
2
Comprehensive Echocardiographic Evaluation
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Echocardiographic examination was performed using Vivid 7 ultrasound machine (GE Medical System, Horten, Norway). Acquired data were stored digitally and analyzed offline using the EchoPAC software (GE Medical System, Horten, Norway). Average values of echocardiographic indices based on readings from three cardiac cycles were used for statistical analyses.
M-mode echocardiography was performed from the standard parasternal short-axis view for measurement of the following indices: LV end-systolic and end-diastolic dimensions, shortening fraction, septal and LV posterior wall thickness, and LV mass.
From the four-chamber view, pulsed-wave Doppler examination was performed to determine transmitral peak early (E) and late (A) diastolic velocities, E wave deceleration time, and E/A ratio. Colour tissue Doppler imaging of the LV lateral wall was performed with frame rates >100 Hz. With the sample volume positioned at the LV lateral wall-mitral annular junction, the mitral annular peak myocardial velocities at systole (s), early diastole (e), and late diastole (a) were measured and the mitral E/e ratio was also calculated. The relatively load-independent index of ventricular systolic function, myocardial acceleration during isovolumic contraction (IVA), was also measured as reported.[18 (link)]
M-mode echocardiography was performed from the standard parasternal short-axis view for measurement of the following indices: LV end-systolic and end-diastolic dimensions, shortening fraction, septal and LV posterior wall thickness, and LV mass.
From the four-chamber view, pulsed-wave Doppler examination was performed to determine transmitral peak early (E) and late (A) diastolic velocities, E wave deceleration time, and E/A ratio. Colour tissue Doppler imaging of the LV lateral wall was performed with frame rates >100 Hz. With the sample volume positioned at the LV lateral wall-mitral annular junction, the mitral annular peak myocardial velocities at systole (s), early diastole (e), and late diastole (a) were measured and the mitral E/e ratio was also calculated. The relatively load-independent index of ventricular systolic function, myocardial acceleration during isovolumic contraction (IVA), was also measured as reported.[18 (link)]
3
Validation of Echocardiographic Strain Analysis
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To determine the clinical utility of DWS for the detection of abnormal strain parameters, we conducted an additional prospective validation study using digital speckle-tracking echocardiography-derived strain measurements. The validation cohort consisted of patients (N = 35) recruited from the Bluhm Cardiovascular Institute echocardiography laboratory. Each patient underwent echocardiography (GE Vivid 7) for research purposes using a pre-defined protocol, which included dedicated, zoomed-in views of the LV in the parasternal short axis and apical 4-, 3-, and 2-chamber views. The sector width and depth were minimized to ensure an adequate frame rate (50–70 fps). PWT measurements and speckle-tracking analysis were performed offline using EchoPAC software (GE Medical Systems, Milwaukee, WI). The speckle-tracking and DWS measurements were made > 3 months apart and both sets of measurements were made in a blinded fashion. All patients enrolled in the validation study provided written, informed consent, and the study was approved the Northwestern University Institutional Review Board.
4
Echocardiography Assessment of Cardiac Structure
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Echocardiography was also only carried out in participants attending the CRFs. Echocardiographic images were obtained using GE Vivid I machines from parasternal long axis and short axis, apical 5-chamber, 4-chamber, 3-chamber, 2-chamber and aortic views along with conventional and tissue Doppler in the 4-chamber view. Image analysis was carried out using GE EchoPac software. Wall and chamber measurements were made according to American Society of Echocardiography/European Association of Echocardiography guidelines32 (link). Measures of left ventricular (LV) structure used as outcomes in analyses were LV mass (LVM), LV end diastolic volume (LVEDV) and relative wall thickness (RWT) which are indicators of LV hypertrophy and remodeling. Indicators of LV diastolic dysfunction, an important risk factor for heart failure, calculated and used as outcomes were left atrial volume (LAV) (a marker of chronically elevated LV filling pressures), the ratio of early (E) to late (A) mitral inflow velocities (E/A), and the ratio of early (E) mitral to early (e′) myocardial velocities (E/e′) (an estimate of LV filling pressure)33 (link),34 (link).
5
Echocardiography and Hemodynamic Analysis of Rat Right Ventricular Function
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After 28 days, rats were fasted overnight and initially anesthetized with isoflurane inhalation. Echocardiography was performed with Visual Sonics Vevo 2100 ultrasoundmachine and 12S rodent probe (GE Healthcare, CT, United States) to determine pulmonary artery acceleration time (PAAT) and tricuspid annulusplain systolic excursion (TAPSE). Data were analyzed with EchoPAC software (GE Healthcare, CT, United States). Then, haemodynamic analysis was performed as previously described (Xia et al., 2018 (link)). Briefly, anesthesia was given to rats with 20% ethylurethanm via injecting intraperitoneally (4 ml/kg). After intubation, right ventricular systolic pressure (RVSP) was recorded. To investigate right ventricular hypertrophy (RVH), the right ventricle (RV), the left ventricle plus septum (LV + S) and the body weight (BW) were weighed, and the RV/(LV + S) ratio and RV/BW ratio were determined.
6
Comprehensive Echocardiographic Evaluation
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Echocardiographic acquisitions were made using Vivid 7 ultrasound machine (General Electric, Vingmed, Horten, Norway). Offline analyses of the recordings were performed using EchoPAC software (General Electric, Vingmed, Horten, Norway). Measurements of all echocardiographic parameters were made in three cardiac cycles and the average was taken for statistical analyses.
From the four-chamber view, RV end-diastolic and end-systolic areas were measured and RV fractional area change was calculated accordingly. Transmitral pulsed-wave Doppler examination was performed to obtain peak early diastolic inflow velocity (E), late diastolic inflow velocity (A), E/A ratio, and E deceleration time. Tissue Doppler echocardiography was performed with sample volume positioned at the basal LV free wall-mitral annular junction to obtain the peak early diastolic myocardial tissue velocity (e), late diastolic myocardial tissue velocity (a), e/a ratio, and E/e ratio. Severity of pulmonary regurgitation was graded semi-quantitatively as mild, moderate, or severe by color flow mapping18 (link).
From the four-chamber view, RV end-diastolic and end-systolic areas were measured and RV fractional area change was calculated accordingly. Transmitral pulsed-wave Doppler examination was performed to obtain peak early diastolic inflow velocity (E), late diastolic inflow velocity (A), E/A ratio, and E deceleration time. Tissue Doppler echocardiography was performed with sample volume positioned at the basal LV free wall-mitral annular junction to obtain the peak early diastolic myocardial tissue velocity (e), late diastolic myocardial tissue velocity (a), e/a ratio, and E/e ratio. Severity of pulmonary regurgitation was graded semi-quantitatively as mild, moderate, or severe by color flow mapping18 (link).
7
Speckle Tracking Echocardiography for LV Diastolic Deformation
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Left ventricular diastolic myocardial deformation in the longitudinal dimension was interrogated using speckle tracking echocardiography as reported previously21 (link). By tracking the entire LV contour, the global LV longitudinal early and late diastolic strain rates were determined from the apical four chamber view using EchoPAC software (GE Medical Systems).
8
Echocardiography Protocol for Cardiovascular Evaluation
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Transthoracic (TTE) and transesophageal (TEE) echocardiography were performed according to national and international recommendations using a GE Vivid E9 system with a M5S phased array and a 6VT probe (GE Healthcare Vingmed Ultrasound AS, Horten, Norway) (5 (link), 6 (link), 7 (link), 8 (link)). All investigations and measurements were performed by experienced investigators (first and last author) who have worked in the field of echocardiography for many years, have the highest national level of accreditation and are national and international teachers in echocardiography. Further, the senior author is an accredited teacher of international 3D echo courses. Echocardiographic analyses were performed using the EchoPac software (version 12.0.1, GE Healthcare Vingmed Ultrasound AS).
9
Multimodal Cardiac Assessment via 3D TTE and Speckle Tracking
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3D TTE was performed using a volumetric sector transducer (GE Vingmed Ultrasound, Horten, Norway). The probe allowed for a real-time evaluation of segments characterized by 30° of depth and 100° of width. The stored data were subsequently subject to offline echocardiographic quantification by means of TomTec software (TomTec Imaging Systems, Unterschleissheim, Germany) in order to assess LVESV, left ventricular end-diastolic volume (LVEDV), left ventricular ejection fraction (LVEF) and wall motion score index (WMSI), as well as the presence and severity of mitral valve insufficiency (MVI). The classification of MVI severity was based on vena contracta width (VC): > 7 mm – severe; 3–7 – mm moderate; < 3 mm – mild [13 (link)].
Based on the data acquired during discharge TTE, left ventricular speckle tracking imaging (STI) was conducted using the offline analysis Echo-PAC software (PC 6.0.0 GE Medical System). Global longitudinal strain (GLS) of LV was calculated as the arithmetic mean of longitudinal strain of all 16 segments of the LV, while anterior global longitudinal strain (AGLS) was derived from the arithmetic mean of anterior wall segments only (1–2, 7–8, 12–16).
Based on the data acquired during discharge TTE, left ventricular speckle tracking imaging (STI) was conducted using the offline analysis Echo-PAC software (PC 6.0.0 GE Medical System). Global longitudinal strain (GLS) of LV was calculated as the arithmetic mean of longitudinal strain of all 16 segments of the LV, while anterior global longitudinal strain (AGLS) was derived from the arithmetic mean of anterior wall segments only (1–2, 7–8, 12–16).
10
Bicycle Exercise Echocardiography Measurements
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Echocardiographic measurements at rest and during exercise were carried out using a Vivid E9 ultrasound system, GE Healthcare, Chicago, Illinois, United States. Data were stored digitally for review and analysis using EchoPAC software, GE Healthcare, Chicago, Illinois, United States.
Bicycle exercise Echo was performed during upright posture. The patient pedals against an increasing workload at a constant cadence. The workload is escalated in a step-wise fashion while imaging is performed. Although imaging can be done throughout the exercise protocol, in most cases, interpretation is based on a comparison of resting and peak exercise images, including chamber dimensions (atria and ventricles), systolic and diastolic function, and tissue Doppler parameters. According to international recommendation, LAVi was determined using the area–length method.[14 (link)] rLAVi was considered as the mean value of three different measures, calculated at rest, in accordance with the American Society of Echocardiography guidelines.[14 (link)]
In the same way, sLAVi was considered as the mean value of three different measures calculated at the peak of bicycle exercise.
Bicycle exercise Echo was performed during upright posture. The patient pedals against an increasing workload at a constant cadence. The workload is escalated in a step-wise fashion while imaging is performed. Although imaging can be done throughout the exercise protocol, in most cases, interpretation is based on a comparison of resting and peak exercise images, including chamber dimensions (atria and ventricles), systolic and diastolic function, and tissue Doppler parameters. According to international recommendation, LAVi was determined using the area–length method.[14 (link)] rLAVi was considered as the mean value of three different measures, calculated at rest, in accordance with the American Society of Echocardiography guidelines.[14 (link)]
In the same way, sLAVi was considered as the mean value of three different measures calculated at the peak of bicycle exercise.
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