Assessing Intracardiac Vortices with High Frame-Rate Echocardiography-Derived Blood Speckle Imaging in Newborns
December 22nd, 2023
The present protocol uses echocardiography-derived blood speckle imaging technology to visualize intracardiac hemodynamics in newborns. The clinical utility of this technology is explored, the rotational body of fluid within the left ventricle (known as a vortex) is accessed, and its significance in understanding diastology is determined.
We're try to explore why preterm babies when they're born preterm and grow into adults have a significant higher risk of heart failure. We think it has to do with an abnormal cardiac development because they were born 10 or sometimes 15 weeks early and where pressure in the heart has changed. We can now capture this kind of changes with looking at intracardiac blood flow patterns with blood speckle imaging.
Hopefully we'll be able to select babies very early on in this crucial period of cardiac development and maybe apply some preventive strategies with a future goal to also prevent heart failure when they grow up to be adults. Well, from a practical point of view, the challenges always fall back on image quality and the acquisition of clear cardiac structures in an echo. And what's more, it's additionally challenging because we're dealing with babies and we sometimes have very unsettled patients.
So we did two studies with blood speckle imaging, one to look if the technique was actually feasible in this population and the answer was yes, it's very feasible. It's very nice images of intracardiac blood flow patterns in these preterm population. And the second we followed the cohort of 80 preterm infant, and we measured them at day five to seven and then again at discharge.
And then we categorized them in the babies who had this cardiac remodeling of prematurity and the ones who did not. And we found out that the babies who had cardiac modeling also had abnormal vortex formations at day seven. The vortexes were way more larger and rounder than in the babies who did not develop cardiac remodeling.
This might be a very important clue moving forward in exploring which babies might be amenable to preventive treatments. Well, currently there's limited research available on the use of echo derived blood speckle imaging and neonates. So what we've currently been doing is looking at cardiac development after preterm birth.
But what remains to be explored is the association between diastolic dysfunction and intracardiac blood flow, like vortices and vortex exclamation. Echo derived blood speckle imaging is a completely non-invasive tool compared to other technologies like MRI. It's also fairly cheap to use and it's very useful as a bedside tool, meaning it can be brought into the rooms next to patients and minimizing inconvenience to the patients.
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Overview
This protocol utilizes echocardiography-derived blood speckle imaging technology to visualize intracardiac hemodynamics in newborns. It aims to understand the implications of abnormal cardiac development in preterm infants and its potential link to future heart failure.
Key Study Components
Area of Science
- Neonatology
- Cardiology
- Imaging Technology
Background
- Preterm infants face a higher risk of heart failure as adults.
- Abnormal cardiac development occurs due to early birth.
- Changes in heart pressure can affect blood flow patterns.
- Understanding these patterns is crucial for preventive strategies.
Purpose of Study
- To explore the relationship between preterm birth and adult heart failure risk.
- To capture intracardiac blood flow patterns using advanced imaging.
- To identify early intervention opportunities for at-risk infants.
Methods Used
- Echocardiography-derived blood speckle imaging technology.
- Visualization of intracardiac hemodynamics.
- Analysis of vortex formation in the left ventricle.
- Assessment of diastolic function in newborns.
Main Results
- Successful visualization of blood flow patterns in newborns.
- Identification of significant hemodynamic changes in preterm infants.
- Insights into the role of left ventricular vortex in diastology.
- Potential for early identification of infants at risk for heart failure.
Conclusions
- Blood speckle imaging is a valuable tool for assessing cardiac health in newborns.
- Understanding hemodynamics can inform preventive strategies for heart failure.
- Further research is needed to validate findings and improve clinical outcomes.
Frequently Asked Questions
Executive Industry Relevance
High frame-rate echocardiography-derived blood speckle imaging (BSI) enables noninvasive, quantitative assessment of intracardiac vortices in newborns, addressing a critical gap in early cardiac function evaluation. This technology supports predictive confidence in identifying subclinical diastolic dysfunction, particularly in preterm infants at risk for adverse cardiac remodeling. Integrating BSI into discovery-stage workflows enhances mechanistic de-risking and informs risk-adjusted advancement decisions for pediatric cardiovascular research portfolios.
Strategic Applications in Biopharma R&D
Early Discovery & Target Validation
- Enables direct visualization of intracardiac blood flow patterns for mechanistic hypothesis testing.
- Supports functional target validation by correlating vortex characteristics with cardiac remodeling phenotypes.
- Facilitates biological de-risking in neonatal and pediatric cardiac models.
- Improves predictive confidence for early-stage cardiovascular biomarker discovery.
Screening & Assay Development
- Provides standardized, reproducible imaging outputs for quantitative assessment of diastolic function.
- Prepares validated biological systems for downstream screening of therapeutic interventions.
- Enables scalable, bedside-compatible assay platforms for pediatric populations.
- Supports reliable evaluation of candidate compounds targeting cardiac remodeling pathways.
Translational & Preclinical Research
- Aligns imaging readouts with disease-relevant endpoints in preclinical cardiac models.
- Ensures continuity from discovery through preclinical validation of diastolic function biomarkers.
- Enables risk-adjusted advancement decisions based on early mechanistic insights.
- Provides translational biomarker data for pediatric and neonatal cardiovascular research.
Pipeline & Workflow Integration
BSI integrates into the discovery-to-preclinical continuum by enabling early, quantitative assessment of cardiac function and remodeling in neonatal models.
- Discovery Biology: Supports hypothesis testing on the mechanistic role of intracardiac vortices in cardiac development.
- Screening: Delivers reproducible, quantitative imaging outputs for assay standardization.
- Analytics: Provides objective measurements of vortex size and morphology for condition comparison.
- Translational Research: Bridges early discovery findings to preclinical biomarker validation in pediatric populations.
- Enterprise Reuse: Establishes a reusable imaging capability for ongoing cardiovascular R&D initiatives.
Operational & Enterprise Impact
- Scientific Value: Increases predictive confidence and reduces mechanistic ambiguity in cardiac target validation.
- Operational Value: Offers standardized, scalable, and noninvasive imaging workflows for neonatal research.
- Strategic Value: Enables earlier go/no-go decisions and capital-efficient portfolio management in pediatric cardiovascular programs.
- Portfolio Impact: Supports risk-adjusted prioritization and advancement of cardiac biomarker and therapeutic candidates.
Implementation Considerations
- Requires expertise in high frame-rate echocardiography and neonatal cardiac imaging.
- Depends on access to advanced ultrasound instrumentation and analytical software for BSI.
- Necessitates cross-team standardization of imaging protocols and data interpretation.
- May require adaptation for use across different neonatal and pediatric model systems.
- Image quality and patient stability can limit data acquisition in unsettled newborns.
