Systems and methods to obtain a myocardial mass index indicative of an at-risk myocardial region

• US 9,591,994 B2
• Filed: 05/12/2011
• Issued: 03/14/2017
• Est. Priority Date: 01/23/2007
• Status: Active Grant

• Current Assignee: DTherapeutics LLC
• Original Assignee: DTherapeutics LLC
• Inventors: Kassab, Ghassan S.
• Primary Examiner(s): Le, John H
• Application Number:
  US13/106,027
• Publication Number:
  US 20110275934A1
• Time in Patent Office: 2,133 Days
• Field of Search: 702/19, 600/407, 600/420, 600/431, 600/481, 424/85.2, 424/85.6, 424/93.71
• US Class Current: 1/1
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 5/1076 for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61B 5/7275 Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• CPC Class Codes: A61B 6/507 for determination of haemodynamic parameters, e.g. perfusion CT
• CPC Class Codes: G06T 2207/30048 Heart; Cardiac
• CPC Class Codes: G06T 2207/30101 Blood vessel; Artery; Vein; Vascular
• CPC Class Codes: G06T 7/0012 Biomedical image inspection
• CPC Class Codes: G06T 7/62 of area, perimeter, diameter or volume
• CPC Class Codes: G16H 30/40 for processing medical images, e.g. editing
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

Systems and methods to obtain a myocardial mass index indicative of an at-risk myocardial region. In at least one embodiment, a method for diagnosing a risk of cardiac disease is provided, the method comprising the steps of identifying a luminal cross-sectional area of a side branch vessel, identifying a luminal cross-sectional area of a main artery most proximal to the side branch vessel, determining a myocardial region at risk for infarct from side branch occlusion relative to a mass perfused by the most proximal artery, wherein such region is based on a relationship between the cross-sectional areas of the side branch and the most proximal main artery, and diagnosing a risk of cardiac disease based on a diameter of the side branch and the size of the myocardial region at risk for infarct perfused by the side branch.

Claims

1. A method for diagnosing a risk of cardiac disease, the method comprising the steps of:

obtaining an image showing a vasculature of at least part of a patient'"'"'s biological tree;

identifying a luminal cross-sectional area of a side branch vessel from the image;

identifying a luminal cross-sectional area of a main artery most proximal to the side branch vessel from the image;

determining a myocardial region at risk for infarct from side branch occlusion relative to a mass perfused by the most proximal artery, wherein such region is a percentage of the mass perfused by the most proximal artery and quantitatively calculated using the cross-sectional areas of the side branch and the most proximal main artery;

diagnosing a risk of cardiac disease based on a diameter of the side branch vessel and a size of the myocardial region at risk for infarct perfused by the side branch, wherein a relationship between the size of the myocardial region at risk for infarct and the cross-sectional area of the side branch is substantially linear; and

administering a treatment to the patient if a risk of cardiac disease at or above a predefined acceptable risk level is diagnosed.

2. The method of claim 1, wherein the step of identifying a luminal cross-sectional area of a side branch vessel is performed by coronary angiography and the treatment comprises bifurcation stenting of the side branch.

3. The method of claim 1, wherein the step of identifying a luminal cross-sectional area of a main artery most proximal to the side branch vessel comprises identifying a luminal cross-sectional area of an artery selected from the group consisting of a left anterior descending artery, a left circumflex artery, and a right coronary artery.

4. The method of claim 1, wherein the side branch vessel is diseased and the diameter of the side branch is calculated using a 7/3 power calculation.

5. The method of claim 1, wherein the step of identifying a luminal cross-sectional area of a side branch vessel is performed using a diameter of a mother vessel of the side branch bifurcation and a diameter of a daughter vessel of the side branch bifurcation.

6. A method for diagnosing a risk of cardiac disease, the method comprising the steps of:

obtaining an image showing a vasculature of at least part of a patient'"'"'s biological tree;

identifying a luminal cross-sectional area of a side branch vessel from the image;

identifying a luminal cross-sectional area of a left main coronary artery from the image;

identifying a luminal cross-sectional area of a right coronary artery from the image;

determining a myocardial region at risk for infarct from side branch occlusion relative to a mass perfused by the entire heart, wherein such region is a percentage of the mass perfused by the entire heart and quantitatively calculated using the cross-sectional areas of the side branch, left main coronary artery and a right coronary artery;

diagnosing a risk of cardiac disease based on a diameter of the side branch and a size of the myocardial region at risk for infarct perfused by the side branch, wherein a relationship between the size of the myocardial region at risk for infarct and the cross-sectional area of the side branch is substantially linear; and

administering a treatment to the patient if a risk of cardiac disease at or above a predefined acceptable risk level is diagnosed.

7. The method of claim 6, wherein the step of identifying a luminal cross-sectional area of a side branch vessel is performed by coronary angiography.

8. The method of claim 6, wherein the side branch vessel is diseased.

9. The method of claim 8, wherein the step of identifying a luminal cross-sectional area of a side branch vessel is performed using a diameter of a mother vessel of the side branch bifurcation and a diameter of a daughter vessel of the side branch bifurcation and a 7/3 power calculation.

10. A system for diagnosing a risk of cardiac disease, the system comprising:

a processor;

a storage medium operably connected to the processor, the storage medium capable of receiving and storing data relative of measurements from a vasculature of a vessel;

wherein the processor is operable to;

produce an image showing a vasculature of at least part of a patient'"'"'s biological tree, the image to be received and stored in the storage medium;

identify a luminal cross-sectional area of a side branch vessel from the image;

identify a luminal cross-sectional area of a main artery most proximal to the side branch vessel from the image;

determine a myocardial region at risk for infarct from side branch occlusion relative to a mass perfused by the most proximal artery, wherein such region is a percentage of the mass perfused by the most proximal artery and quantitatively calculated using the cross-sectional areas of the side branch and the most proximal main artery, wherein a relationship between the size of the myocardial region at risk for infarct and the cross-sectional area of the side branch is substantially linear; and

diagnose a risk of cardiac disease based on a diameter of the side branch and a size of the myocardial region at risk for infarct perfused by the side branch.

11. The system of claim 10, wherein the identification of a luminal cross-sectional area of a side branch vessel is performed by coronary angiography.

12. The system of claim 10, wherein the main artery most proximal to the side branch vessel comprises the left anterior descending artery.

13. The system of claim 10, wherein the main artery most proximal to the side branch vessel comprises the left circumflex artery.

14. The system of claim 10, wherein the main artery most proximal to the side branch vessel comprises the right coronary artery.

15. The system of claim 10, wherein the side branch vessel is diseased.

16. The system of claim 15, wherein the identification of a luminal cross-sectional area of a side branch vessel is performed using a diameter of a mother vessel of the side branch bifurcation and a diameter of a daughter vessel of the side branch bifurcation.

17. A system for diagnosing a risk of cardiac disease, the system comprising:

a processor;

a storage medium operably connected to the processor, the storage medium capable of receiving and storing data relative of measurements from a vasculature of a vessel;

wherein the processor is operable to;

produce an image showing a vasculature of at least part of a patient'"'"'s biological tree, the image to be received and stored in the storage medium;

identify a lumen area of a side branch vessel from the image;

identify a cross sectional area of a left main coronary artery from the image;

identify a cross sectional area of a right coronary artery from the image;

determine a myocardial region at risk for infarct from side branch occlusion relative to a mass perfused by the entire heart, wherein such region is a percentage of the mass perfused by the entire heart and quantitatively calculated using the cross-sectional areas of the side branch, left main coronary artery, and right coronary artery, wherein a relationship between the size of the myocardial region at risk for infarct and the cross-sectional area of the side branch is substantially linear; and

diagnose a risk of cardiac disease based on a diameter of the side branch and a size of the myocardial region at risk for infarct perfused by the side branch.

18. The system of claim 17, wherein the identification of a luminal cross-sectional area of a side branch vessel is performed by coronary angiography.

19. The system of claim 17, wherein the side branch vessel is diseased.

20. The system of claim 19, wherein the identification of a luminal cross-sectional area of a side branch vessel is performed using a diameter of a mother vessel of the side branch bifurcation and a diameter of a daughter vessel of the side branch bifurcation.