Impact of Loading and Myocardial Mechanical Properties on Natural Shear Waves

Bezy, S; Duchenne, Jürgen; Orlowska, M; Caenen, Annette; Amoni, Matthew; Ingelaere, Sebastian; Wouters, Laurine; McCutcheon, Keir; Minten, Lennert; Puvrez, A; D’hooge, Jan; Voigt, Jens‐Uwe

doi:10.1016/j.jcmg.2022.07.011

Cited by 15 publications

(3 citation statements)

References 26 publications

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“…Vital signs, including heart rate, oxygen saturation, and arterial blood pressure, were monitored. It should be noted that the animals were the same as in our previous study 10 , which focused on wave speed measurements after mitral valve closure.…”

Section: Methodsmentioning

confidence: 99%

Continuous shear wave measurements for dynamic cardiac stiffness evaluation in pigs

Caenen,

Keijzer,

Bézy

et al. 2023

Sci Rep

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Ultrasound-based shear wave elastography is a promising technique to non-invasively assess the dynamic stiffness variations of the heart. The technique is based on tracking the propagation of acoustically induced shear waves in the myocardium of which the propagation speed is linked to tissue stiffness. This measurement is repeated multiple times across the cardiac cycle to assess the natural variations in wave propagation speed. The interpretation of these measurements remains however complex, as factors such as loading and contractility affect wave propagation. We therefore applied transthoracic shear wave elastography in 13 pigs to investigate the dependencies of wave speed on pressure–volume derived indices of loading, myocardial stiffness, and contractility, while altering loading and inducing myocardial ischemia/reperfusion injury. Our results show that diastolic wave speed correlates to a pressure–volume derived index of operational myocardial stiffness (R = 0.75, p < 0.001), suggesting that both loading and intrinsic properties can affect diastolic wave speed. Additionally, the wave speed ratio, i.e. the ratio of systolic and diastolic speed, correlates to a pressure–volume derived index of contractility, i.e. preload-recruitable stroke work (R = 0.67, p < 0.001). Measuring wave speed ratio might thus provide a non-invasive index of contractility during ischemia/reperfusion injury.

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Section: Methodsmentioning

confidence: 99%

Continuous shear wave measurements for dynamic cardiac stiffness evaluation in pigs

Caenen,

Keijzer,

Bézy

et al. 2023

Sci Rep

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“…Shear waves can be naturally induced in the heart by the closure of the atrioventricular or semilunar valves themselves, but they can also be induced mechanically using an external source 57 . In a recent animal study, Bézy et al 58 . demonstrated a strong correlation between shear wave speed and the chamber stiffness constant β after mitral valve closure in a pig model ( r = .63, p < .001).…”

Section: Echocardiographic Evaluation Of LV Myocardial Stiffnessmentioning

confidence: 99%

Evaluation of left ventricular stiffness with echocardiography

Zhang,

Tang,

Zhang

et al. 2024

Echocardiography

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Half of patients with heart failure are presented with preserved ejection fraction (HFpEF). The pathophysiology of these patients is complex, but increased left ventricular (LV) stiffness has been proven to play a key role. However, the application of this parameter is limited due to the requirement for invasive catheterization for its measurement. With advances in ultrasound technology, significant progress has been made in the noninvasive assessment of LV chamber or myocardial stiffness using echocardiography. Therefore, this review aims to summarize the pathophysiological mechanisms, correlations with invasive LV stiffness constants, applications in different populations, as well as the limitations of echocardiography‐derived indices for the assessment of both LV chamber and myocardial stiffness. Indices of LV chamber stiffness, such as the ratio of E/e' divided by left ventricular end‐diastolic volume (E/e'/LVEDV), the ratio of E/SRe (early diastolic strain rates)/LVEDV, and diastolic pressure‐volume quotient (DPVQ), are derived from the relationship between echocardiographic parameters of LV filling pressure (LVFP) and LV size. However, these methods are surrogate and lumped measurements, relying on E/e' or E/SRe for evaluating LVFP. The limitations of E/e' or E/SRe in the assessment of LVFP may contribute to the moderate correlation between E/e'/LVEDV or E/SRe/LVEDV and LV stiffness constants. Even the most validated measurement (DPVQ) is considered unreliable in individual patients. In comparison to E/e'/LVEDV and E/SRe/LVEDV, indices like time‐velocity integral (TVI) measurements of pulmonary venous and transmitral flows may demonstrate better performance in assessing LV chamber stiffness, as evidenced by their higher correlation with LV stiffness constants. However, only one study has been conducted on the exploration and application of TVI in the literature, and the accuracy of assessing LV chamber stiffness remains to be confirmed. Regarding echocardiographic indices for LV myocardial stiffness evaluation, parameters such as epicardial movement index (EMI)/ diastolic wall strain (DWS), intrinsic velocity propagation of myocardial stretch (iVP), and shear wave imaging (SWI) have been proposed. While the alteration of DWS and its predictive value for adverse outcomes in various populations have been widely validated, it has been found that DWS may be better considered as an overall marker of cardiac function performance rather than pure myocardial stiffness. Although the effectiveness of iVP and SWI in assessing left ventricular myocardial stiffness has been demonstrated in animal models and clinical studies, both indices have their limitations. Overall, it seems that currently no echocardiography‐derived indices can reliably and accurately assess LV stiffness, despite the development of several parameters. Therefore, a comprehensive evaluation of LV stiffness using all available parameters may be more accurate and enable earlier detection of alterations in LV stiffness.

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“…A difference between various degrees of pathological stiffness (nonablated HCM myocardium vs. myocardial scar tissue in ablated segments) could be detected. [51] Cardiac amyloidosis is a group of infiltrative disorders characterized by extracellular deposition of amyloid fibrils in organs and tissues. [52] The prognosis is poor, especially when there is cardiac involvement.…”

Section: Shear Wave Imagingmentioning

confidence: 99%

Translating High-Frame-Rate Imaging into Clinical Practice: Where Do We Stand?

Popescu

Bezy

Voigt

2023

Romanian Journal of Cardiology

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Continuous developments in cardiovascular imaging, software, and hardware have led to technological advancements that open new ways for assessing myocardial mechanics, hemodynamics, and function. The technical shift from clinical ultrasound machines that rely on conventional line-per-line beam transmissions to ultrafast imaging based on plane or diverging waves provides very high frame rates of up to 5000 Hz with a wide variety of potential new applications, including shear wave imaging, ultrafast speckle tracking, intracardiac flow imaging, and myocardial perfusion imaging. This review provides an overview of these advances and demonstrates potential applications and their possible added value in clinical practice.

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Impact of Loading and Myocardial Mechanical Properties on Natural Shear Waves

Cited by 15 publications

References 26 publications

Continuous shear wave measurements for dynamic cardiac stiffness evaluation in pigs

Continuous shear wave measurements for dynamic cardiac stiffness evaluation in pigs

Evaluation of left ventricular stiffness with echocardiography

Translating High-Frame-Rate Imaging into Clinical Practice: Where Do We Stand?

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