Key result
Aortic shear wave velocity was significantly higher in hypertrophic cardiomyopathy patients than healthy volunteers (5.1 vs 3.61 m/s, P<0.0001), with a 4 m/s threshold yielding 95% sensitivity and 90% specificity.
Why the study?
The study was conducted to demonstrate the clinical relevance of measuring the propagation velocity of naturally occurring shear waves generated by aortic and mitral valve closure using high frame rate tissue Doppler.
Can naturally occurring shear wave velocity measured by high frame rate tissue Doppler differentiate between normal and hypertrophic cardiomyopathy myocardium?
Cross-Sectional (n=88)
Can naturally occurring shear wave velocity measured by high frame rate tissue Doppler differentiate between normal and hypertrophic cardiomyopathy myocardium?
Absolute Event Rate: 5.1% vs 3.61%
p-value: p=<0.0001
Naturally occurring shear wave velocity measured by high frame rate tissue Doppler can accurately differentiate between normal myocardium and hypertrophic cardiomyopathy.
May support aortic shear wave velocity as a biomarker in hypertrophic cardiomyopathy; leaves open diagnostic utility pending prospective validation.
We apply a high frame rate (over 500 Hz) tissue Doppler method to measure the propagation velocity of naturally occurring shear waves (SW) generated by aortic and mitral valves closure. The aim of this work is to demonstrate clinical relevance. We included 45 healthy volunteers and 43 patients with hypertrophic cardiomyopathy (HCM). The mitral SW (4.68 ± 0.66 m/s) was consistently faster than the aortic (3.51 ± 0.38 m/s) in all volunteers (p < 0.0001). In HCM patients, SW velocity correlated with E/e' ratio (r = 0.346, p = 0.04 for aortic SW and r = 0.667, p = 0.04 for mitral SW). A subgroup of 20 volunteers were matched for age and gender to 20 HCM patients. In HCM, the mean velocity of 5.1 ± 0.7 m/s for the aortic SW (3.61 ± 0.46 m/s in matched volunteers, p < 0.0001) and 6.88 ± 1.12 m/s for the mitral SW(4.65 ± 0.77 m/s in matched volunteers, p < 0.0001). A threshold of 4 m/s for the aortic SW correctly classified pathologic myocardium with a sensitivity of 95% and specificity of 90%. Naturally occurring SW can be used to assess differences between normal and pathologic myocardium.
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Strachinaru et al. (2019) conducted a cross-sectional in Hypertrophic cardiomyopathy (n=88). Hypertrophic cardiomyopathy vs. Healthy volunteers was evaluated on Aortic shear wave velocity (p=<0.0001). Aortic shear wave velocity was significantly higher in hypertrophic cardiomyopathy patients than healthy volunteers (5.1 vs 3.61 m/s, P<0.0001), with a 4 m/s threshold yielding 95% sensitivity and 90% specificity.
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