Method for Aortic Wall Strain Measurement With Three-Dimensional Ultrasound Speckle Tracking and Fitted Finite Element Analysis Konstantinos Karatolios,

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Method for Aortic Wall Strain Measurement With Three-Dimensional Ultrasound Speckle Tracking and Fitted Finite Element Analysis Konstantinos Karatolios, MD, Andreas Wittek, Dipl.-Ing. (FH), Thet Htar Nwe, PhD, Peter Bihari, MD, Amit Shelke, PhD, Dennis Josef, Thomas Schmitz-Rixen, MD, Josef Geks, MD, Bernhard Maisch, MD, Christopher Blase, PhD, Rainer Moosdorf, MD, Sebastian Vogt, MD The Annals of Thoracic Surgery Volume 96, Issue 5, Pages 1664-1671 (November 2013) DOI: 10.1016/j.athoracsur.2013.06.037 Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Representative example of a three-dimensional speckle tracking image of the abdominal aorta obtained in a healthy volunteer. The 5-plane view consists of a longitudinal view in plane A, a longitudinal view orthogonal to plane A (plane B) and 3 short axis views (planes C3, C5, and C7). The Annals of Thoracic Surgery 2013 96, 1664-1671DOI: (10.1016/j.athoracsur.2013.06.037) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Processing of three-dimensional (3D) wall motion tracking data. (A) The exported measurement points (36 × 36 points) are processed and represented as a 3D point cloud including the artificial pseudo-apex. (B) Point field of the luminal surface of the aortic wall without pseudo-apex. (C) Finite element discretization with first order 4 node membrane elements. (D) Longitudinal and circumferential directions of local element coordinate systems. Mesh and coordinate systems were generated by a custom written Finite Element-preprocessor. The Annals of Thoracic Surgery 2013 96, 1664-1671DOI: (10.1016/j.athoracsur.2013.06.037) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Spatially resolved circumferential strain (CS) of a segment of the abdominal aorta in (A) a healthy volunteer and (B) a patient with an abdominal aortic aneurysm (AAA). Blue indicates areas with reduced strain, whereas yellow and red indicate areas with higher strain. The CS is greater in the healthy volunteer compared with the patient with an AAA as displayed by the corresponding color scale. The Annals of Thoracic Surgery 2013 96, 1664-1671DOI: (10.1016/j.athoracsur.2013.06.037) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Circumferential strain (CS) of the abdominal aorta in (A) a healthy volunteer and (B) a patient with an abdominal aortic aneurysm (AAA) during 1 heart cycle. The CS curves from different spatial segments show a synchronous course in the healthy volunteer, whereas CS is dyssynchronous in the AAA. Peak CS are reduced and occur with temporal delay in the AAA compared with the healthy volunteer. The Annals of Thoracic Surgery 2013 96, 1664-1671DOI: (10.1016/j.athoracsur.2013.06.037) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions