Vevo 2100 System Cardio Measurements. Dieter Fuchs, PhD FUJIFILM VisualSonics, Inc.

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Vevo 2100 System Cardio Measurements Dieter Fuchs, PhD FUJIFILM VisualSonics, Inc. dfuchs@visualsonics.com

Instructions This document is a guideline on how to assess cardiac function in rodents imaged with a Vevo 1100 or Vevo 2100 system All data analysis was done using the Vevo LAB desktop software* Please note that it is up to the user to decide which of the available measurements are most applicable *Please contact you VisualSonics representative for more information on the Vevo LAB software

Automated Zoom The automated zoom function during any measurement allows precise quantification

Measurements All measurement packages are accessible via the Measurements icon Simply open a cineloop or frame and click on

Systolic Parameters

Systolic Parameters Various options to calculate systolic parameters Which measurement should be used depends on the model imaged LV-Trace Long axis M-Mode Short- or long axis Simpson s Short- and long axis EndoArea & -Major Short- and long axis PW Doppler Mode + outflow tract

LV Trace in B-Mode Long Axis View LV Trace is part of the LV Analysis Package

LV Trace Tool in B-Mode Workflow 1) Select Cardiac Package 2) Select PLAX 3) Select LV Trace LV-Trace for outlining the endocardium in end systole and end diastole

LV Trace Tool in B-Mode Place measurements in the following order: 1) Aortic root 2 clicks 2) Apex 3) Anterior wall 4) Posterior wall 5) Repeat 3+4 until the wall is outlined 2 4,6,8... 3,5,7... 1

LV Trace Tool in B-Mode Vevo LAB will highlight end-diastole (red) and end-systole (green) automatically They are used for assessing systolic parameters

LV Trace Tool in B-Mode Calculated Parameters Stroke Volume (SV) Ejection fraction (EF) Cardac output (CO) Fractional shortening (FS) Please note that the longitudinal shortening is calculated

LV Trace in M-Mode Long or Short Axis View LV Trace is part of the LV Analysis Package

LV Trace Tool in M-Mode Workflow 1) Select Cardiac Package 2) Select PLAX or SAX 3) Select LV Trace LV-Trace for outlining the end- and epicardium through multiple cardiac cycles

LV Trace Tool in M-Mode Place the following measurements in your preferred order: 1) Anterior a. Epicard b. Endocard 2) Posterior a. Endocard b. Epicard 1a 1b 2a 2b Left click Right click Each trace has to be completed by clicking the right mouse button

LV Trace Tool in M-Mode Vevo LAB will highlight end-diastole (red) and end-systole (green) automatically They are used for assessing systolic parameters

LV Trace Tool in M-Mode Calculated Parameters Stroke Volume (SV) Ejection fraction (EF) Cardac output (CO) Fractional shortening (FS) LV Mass Only if epicard is traced

M-Mode Long or Short Axis View

M-Mode Workflow 1) Select Cardiac Package 2) Select PLAX or SAX 3) Select IVS Measuring distances between anterior and posterior endocard

M-Mode Place the following measurements in the following order: 1) Anterior wall a. Epicard b. Endocard 2) Posterior wall a. Endocard b. Epicard Do this for IVS,s and IVS,d 1a 1b 2a 2b

M-Mode Calculated Parameters Ejection fraction (EF) Fractional shortening (FS) LV Mass Note that duplicated measurements will automatically be used for calculating average and standard deviation

Simpson s 1 Long and 3 Short Axis Views

Systolic Function Measurement According to Simpson Workflow 1) Select Cardiac Package 2) Select Simpson s SimpLength Measurements from one long axis and three short axis views are required

Systolic Function Measurement According to Simpson Place the following measurements in your preferred order: 1) Long axis a. SimpLenght,s b. SimpLength,d Lenght: Distance aortic root to apical endocard in systole and diastole (two measurements)

Systolic Function Measurement According to Simpson Place the following measurements in your preferred order: 1) Short axis proximal a. SimpAreaProx,s b. SimpAreaProx,d 2) Short axis mid a. SimpAreaMid,s b. SimpAreaMid,d 3) Short axis distal a. SimpAreaDist,s b. SimpAreaDist,d

Systolic Function According to Simpson Calculated Parameters Stroke Volume ( Simp SV) Fractional Area Change (Simp FAC) Ejection fraction (Simp EF) Fractional shortening (Simp FS) Cardac output (Simp CO)

ENDO/EPImajr 1 Long and 1 Short Axis View

Systolic Function Measurement with ENDOmajr/area Workflow 1) Select Cardiac Package 2) Select PLAX or SAX ENDOmajr Measurements from one long axis and one short axis views are required

Systolic Function Measurement with ENDOmajr/area Place the following measurements in your preferred order: 1) Long axis a. ENDOmajr,s b. ENDOmajr,d 2) Long axis a. EPImajr,s b. EPImajr,d Point 2) is optional, as measuring EPImajr,d and EPImajr,s are for calculating LV Mass

Systolic Function Measurement with ENDOmajr/area Place the following measurements in your preferred order: 1) Short axis a. ENDOarea,s b. ENDOare,d 2) Short axis a. EPIarea,s b. EPIarea,d Point 2) is optional, as measuring EPIarea,d and EPIarea,s are for calculating LV Mass

Systolic Function Measurement with ENDOmajr/area LV Mass Stroke Volume (SV) Fractional shortening (FS) Fractional Area Change (FAC) Ejection Fraction (EF) Cardiac Output (CO)

Cardiac Output Pulsed-Wave (PW) Doppler Mode

Systolic Function Assessed with PW Doppler Mode Determining vessel diameter Vessel blood flow Calculating Blood volume per heart beat Stroke volume (SV) Blood volume per time Cardiac output (CO)

Systolic Function Assessed with PW Doppler Mode Workflow 1) Select Cardiac Package 2) Select AoV Flow 3) Measure AoV Diam in B-Mode AoV VTI in PW Doppler Mode Measurements from the supersternal view in B Mode and PW Doppler Mode

Systolic Function Assessed with PW Doppler Mode Place the following measurements in your preferred order: 1) B-Mode a. AoV Diam 2) PW Doppler Mode a. AoV VTI AoV: measured outside the left ventricle (LVOT measured before the aortic valves) Video &

Systolic Function Assessed with PW Doppler Mode Blood flow through the ascending aorta: 1) Select automated tracing 2) Assess flow using AoV VTI Left click Right click Automated averaging when selecting multiple cardiac cycles

Systolic Function Assessed with PW Doppler Mode Stroke Volume AoV SV Cardac output AoV CO SV and CO can be assessed by similar measurements on the Pulmonary artery

Diastolic Parameters Color Doppler Mode PW Doppler Mode Tissue Doppler Mode* * Tissue Doppler Mode only availabel on Vevo 2100 and Vevo LAZR systems

Distolic Function Workflow Workflow 1) Apical view in B-Mode 2) Optimize view in Color Doppler Mode Video

Distolic Function Workflow Workflow 1) Apical view in B-Mode 2) Optimize view in Color Doppler Mode 3) Assess Mitral flow in PW Doppler Mode

Distolic Function Workflow Workflow 1) Apical view in B-Mode 2) Optimize view in Color Doppler Mode 3) Assess Mitral flow in PW Doppler Mode 4) Assess valve movement in Tissue Doppler Mode* * Tissue Doppler Mode only availabel on Vevo 2100 and Vevo LAZR systems

Distolic Function Calculations* E/A ratio Myocardial Performance Index MPI E/E ratio E /A ratio E/E' ratio can detect left ventricular diastolic dysfunction more sensitively than the ratio of E to mitral peak velocity of late filling (A) (E/A ratio). * Not all calculations listed

Questions? VisualSonics Insight through in vivo imaging www.visualsonics.com