Author + information
- Received July 11, 2018
- Revision received November 25, 2018
- Accepted November 28, 2018
- Published online March 13, 2019.
- Aniela Petrescu, MDa,∗,
- Pedro Santos, PhDb,∗,
- Marta Orlowska, MScb,
- João Pedrosa, PhDb,
- Stéphanie Bézy, MSca,
- Bidisha Chakraborty, MScb,
- Marta Cvijic, MD, PhDa,
- Monica Dobrovie, MDa,
- Michel Delforge, MD, PhDc,
- Jan D’hooge, PhDb,† and
- Jens-Uwe Voigt, MD, PhDa,†∗ ()
- aDepartment of Cardiovascular Science, Division of Cardiology, University Hospital Leuven, University of Leuven, Leuven, Belgium
- bDepartment of Cardiovascular Science, Cardiovascular Imaging and Dynamics, University Hospital Leuven, University of Leuven, Leuven, Belgium
- cDepartment of Hematology, University Hospital Leuven, University of Leuven, Leuven, Belgium
- ↵∗Address for correspondence:
Prof. Dr. Jens-Uwe Voigt, University of Leuven and University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
Objectives This study sought to evaluate whether velocity of naturally occurring myocardial shear waves (SW) could relate to myocardial stiffness (MS) in vivo.
Background Cardiac SW imaging has been proposed as a noninvasive tool to assess MS. SWs occur after mechanical excitation of the myocardium (e.g., mitral valve closure [MVC] and aortic valve closure [AVC]), and their propagation velocity is theoretically related to MS, thus providing an opportunity to assess stiffness at end-diastole (ED) and end-systole. However, given that SW propagation in vivo is complex, it remains unclear whether natural SW velocity effectively relates to MS.
Methods This study prospectively enrolled 50 healthy volunteers (HV) (43.7 ± 17.1 years of age) and 18 patients with cardiac amyloidosis (CA) (68.0 ± 9.8 years of age). HV were divided into 3 age groups: group I, 20 to 39 years of age (n = 24); group II, 40 to 59 years of age (n = 11); and group III, 60 to 80 years of age (n = 15). Parasternal long-axis views were acquired using an experimental scanner. Tissue (Doppler) acceleration maps were extracted from an anatomical M-mode along the midline of the left ventricular septum.
Results SW propagation velocity was significantly higher in CA patients than in HV after both MVC (3.54 ± 0.93 m/s vs. 6.33 ± 1.63 m/s, respectively; p < 0.001) and AVC (3.75 ± 0.76 m/s vs. 5.63 ± 1.13 m/s, respectively; p < 0.001). Similarly, SW propagation velocity differed significantly among age groups in HV, with a significantly higher value for group III than for group I, both occurring after MVC (p < 0.001) and AVC (p < 0.01). Moreover, SW propagation velocity after MVC was found to be significantly higher in patients with an increasing grade of diastolic dysfunction (p < 0.001). Finally, positive correlation was found between SW velocities after MVC and mitral inflow-to-mitral relaxation velocity ratio (E/E′) (r = 0.74; p = 0.002).
Conclusions End-diastole SW velocities were significantly higher in patients with CA, patients with a higher grade of diastolic dysfunction, and elderly volunteers. These findings thus suggest that the speed of naturally induced SWs may be related to MS.
↵∗ Drs. Petrescu and Santos contributed equally to this study.
↵† Drs. D’hooge and Voigt are senior authors.
Supported by European Research Council grants FP7/2007-2013 and ERC/281748 and Research Foundation-Flanders grants FWO/G002617N and FWO/G092318N. Dr. Petrescu is supported by a German Society of Cardiology research grant. Dr. Cvijic is supported by a European Association of Cardiovascular Imaging research grant. Dr. D'hooge performs research under contracts for GE Vingmed Healthcare and Cairdac. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received July 11, 2018.
- Revision received November 25, 2018.
- Accepted November 28, 2018.
- 2019 American College of Cardiology Foundation
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