Shear Wave Elastography Using High-Frame-Rate Imaging in the Follow-Up of Heart Transplantation Recipients

The purpose of this study was to investigate whether propagation velocities of naturally occurring shear waves (SWs) at mitral valve closure (MVC) increase with the degree of diffuse myocardial injury (DMI) and with invasively determined LV filling pressures as a reflection of an increase in myocard...

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Published in:JACC. Cardiovascular imaging 2020-11, Vol.13 (11), p.2304-2313
Main Authors: Petrescu, Aniela, Bézy, Stéphanie, Cvijic, Marta, Santos, Pedro, Orlowska, Marta, Duchenne, Jürgen, Pedrosa, João, Van Keer, Jan M., Verbeken, Eric, von Bardeleben, Stephan, Droogne, Walter, Bogaert, Jan, Van Cleemput, Johan, D’hooge, Jan, Voigt, Jens-Uwe
Format: Article
Language:English
Subjects:
Diastole
Elasticity Imaging Techniques
Follow-Up Studies
Heart Transplantation
high-frame-rate echocardiography
Humans
myocardial stiffness
Predictive Value of Tests
shear wave
Ventricular Dysfunction, Left
Ventricular Function, Left
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Summary:The purpose of this study was to investigate whether propagation velocities of naturally occurring shear waves (SWs) at mitral valve closure (MVC) increase with the degree of diffuse myocardial injury (DMI) and with invasively determined LV filling pressures as a reflection of an increase in myocardial stiffness in heart transplantation (HTx) recipients. After orthotopic HTx, allografts undergo DMI that contributes to functional impairment, especially to increased passive myocardial stiffness, which is an important pathophysiological determinant of left ventricular (LV) diastolic dysfunction. Echocardiographic SW elastography is an emerging approach for measuring myocardial stiffness in vivo. Natural SWs occur after mechanical excitation of the myocardium, for example, after MVC, and their propagation velocity is directly related to myocardial stiffness, thus providing an opportunity to assess myocardial stiffness at end-diastole. A total of 52 HTx recipients who underwent right heart catheterization (all) and cardiac magnetic resonance (CMR) (n = 23) during their annual check-up were prospectively enrolled. Echocardiographic SW elastography was performed in parasternal long axis views of the LV using an experimental scanner at 1,135 ± 270 frames per second. The degree of DMI was quantified with T1 mapping. SW velocity at MVC correlated best with native myocardial T1 values (r = 0.75; p 
ISSN:1936-878X
1876-7591
DOI:10.1016/j.jcmg.2020.06.043