Key result
Epicardial ShearWave imaging successfully measured cardiac elastometry (mean 15.3 ± 5.3 kPa) during open-chest surgery, with values >18 kPa associated with older age, smaller LV, and higher BNP.
Why the study?
Cardiac stiffness is a marker of diastolic function with strong prognostic significance that is not measurable in clinical practice.
Is it feasible to directly measure cardiac stiffness using epicardial ShearWave imaging during open-chest surgery in humans?
Observational (n=33)
Is it feasible to directly measure cardiac stiffness using epicardial ShearWave imaging during open-chest surgery in humans?
Epicardial ShearWave imaging is a feasible method to directly measure cardiac stiffness during open-chest surgery, with higher elastometry values correlating with known markers of diastolic dysfunction.
Feasible for intraoperative stiffness measurement; leaves open clinical utility in diastolic assessment pending validation.
PURPOSE: Cardiac stiffness is a marker of diastolic function with a strong prognostic significance in many heart diseases that is not measurable in clinical practice. This study investigates whether elastometry, a surrogate for organ stiffness, is measurable in the heart using ShearWave Imaging. METHODS: In 33 anesthetized patients scheduled for cardiac surgery, ShearWave imaging was acquired epicardially using a dedicated ultrasound machine on the left ventricle parallel to the left anterior descending coronary artery in a loaded heart following the last cardiac beat. Cardiac elastometry was measured offline using the Young modulus with customized software. RESULTS: Overall, the ejection fraction was 61 ± 10%. E/A and E/e' ratios were 1.0 ± 0.5 and 10.5 ± 4.1, respectively. Cardiac elastometry averaged 15.3 ± 5.3 kPa with a median of 18 kPa. Patients with high elastometry >18 kPa were older (P = .04), had thicker (P = .02) but smaller LV (P = .004), had larger left atria (P = .05) and a higher BNP level (P = .04). We distinguished three different transmural elastometry patterns: higher epicardial, higher endocardial, or uniformly distributed elastometry. CONCLUSION: Elastometry measurement was feasible for the human heart. This surrogate for cardiac stiffness dichotomized patients with low and high elastometry, and provided three different phenotypes of transmural elastometry with link to diastolic function.
No takes yet. Share an insight, caveat, or question.
Saloux et al. (2020) conducted an observational in Patients scheduled for cardiac surgery (n=33). ShearWave Imaging was evaluated on Cardiac elastometry (Young modulus). Epicardial ShearWave imaging successfully measured cardiac elastometry (mean 15.3 ± 5.3 kPa) during open-chest surgery, with values >18 kPa associated with older age, smaller LV, and higher BNP.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: