Myocardial Stiffness Assessment Using Shear Wave Imaging in Pediatric Hypertrophic Cardiomyopathy

Naturally Occurring Shear Waves in Healthy Volunteers and Hypertrophic Cardiomyopathy Patients

“…In several studies, the detection of these fast phenomena in the heart has been described (Pernot et al 2011;Hollender et al 2012;Song et al 2013;Urban et al 2013;Vejdani-Jahromi et al 2017;Villemain et al 2018aVillemain et al , 2018bBrekke et al 2014;Kanai et al 2000;Kanai 2005Kanai , 2009Couade et al 2011;Pislaru et al 2017) using experimental systems or modified software. We have already demonstrated that by tuning the relationship between the depth of the image, the 2-D line density, sector width and the TDI field of view sufficient time resolution can be achieved, allowing visualization Fig.…”

“…The effects of myocardial fiber structure on the wave velocity can be quite significant, which may result in anisotropic shear wave propagation as observed with radiation force-induced shear wave elastography (Villemain et al 2018a(Villemain et al , 2018bUrban et al 2016). Yet, the relatively low oscillation frequency (order 50À100 Hz) of the waves might reduce the effect of the fiber structure (Song et al 2016.…”

“…Pediatric and adult HCM patients have already been tested by using shear wave imaging (Villemain et al 2018a(Villemain et al , 2018b. These investigations were performed with ultrafast special equipment and externally induced shear waves, and demonstrated a significantly higher shear wave velocity (difference of 1.5 m/s) in HCM patients with proven decreased LV compliance and higher degree of fibrosis.…”

“…The main present-day applications are liver fibrosis and breast, thyroid, prostate, kidney and lymph node imaging (Shiina et al 2015;Parker et al 2011). Several research groups have used external sources to induce shear waves in the myocardium (Bouchard et al 2009;Pernot et al 2011;Hollender et al 2012;Song et al 2013;Urban et al 2013;Vejdani-Jahromi et al 2017), demonstrating that diastolic myocardial stiffness can be determined using ultrasonic shear wave imaging (Villemain et al 2018a(Villemain et al , 2018b. It has been found that shear-like waves also naturally occur in the myocardium after valve closure (Kanai 2009;Brekke et al 2014), caused by the impulse of the snapping valve on the mitral and aortic annuli which propagates within the cardiac wall.…”

“…In this work, we study naturally occurring shear waves in normal volunteers and hypertrophic cardiomyopathy (HCM) patients, as a pathologic model of increased muscle stiffness and diastolic dysfunction (Villemain et al 2018a(Villemain et al , 2018bElliott et al 2014;Lu et al 2018;Finocchiaro et al 2018). The aim was to demonstrate the feasibility in a clinical setting and investigate the potential application of the method for discriminating normal from pathologic myocardium.…”