Role of Shear Wave Elastography in the Assessment of Myocardial Stiffness in Various Cardiomyopathies

Abstract

Echocardiography is essential for the diagnosis and treatment of cardiovascular disease. Assessing left ventricle diastolic function is a major challenge, and several wellknown ultrasound techniques, such as pulsed Doppler for mitral flow, tissue Doppler, and myocardial strain, are used to non-invasively estimate left atrial filling pressure. Although widely available, this approach has several limitations and does not truly represent the intrinsic properties of the cardiac muscle. However, cardiac elastography can be studied noninvasively by estimating myocardial stiffness through shear wave propagation speed in cardiac tissue. Elastography is already widely used to assess stiffness in other tissue types, such as thyroid, liver, and breast. In the context of cardiological assessment, this technique has already been successfully used in diseases such as cardiac amyloidosis and hypertrophic cardiomyopathy. This article aims to review the main concepts of this promising technique and present the published experiences of national and international services.