Continuous shear wave measurements for dynamic cardiac stiffness evaluation in pigs
Annette Caenen (Universiteit Gent, Erasmus MC, Katholieke Universiteit Leuven)
Lana Keijzer (Erasmus MC)
Stéphanie Bézy (Katholieke Universiteit Leuven)
Jürgen Duchenne
Marta Orlowska (Katholieke Universiteit Leuven)
Antonius F.W. Van Der Steen (Erasmus MC)
Nico De Jong (TU Delft - ImPhys/De Jong group, Erasmus MC)
Johan G. Bosch (Erasmus MC)
Jens Uwe Voigt (Katholieke Universiteit Leuven)
Jan D’hooge
Hendrik J. Vos (Erasmus MC, TU Delft - ImPhys/Verweij group)
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Abstract
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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