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Liu HC, Lee HK, Urban MW, Zhou Q, Kijanka P. Acoustic radiation force-induced longitudinal shear wave for ultrasound-based viscoelastic evaluation. ULTRASONICS 2024; 142:107389. [PMID: 38924960 PMCID: PMC11298294 DOI: 10.1016/j.ultras.2024.107389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 06/28/2024]
Abstract
Acoustic radiation force (ARF) is widely used to induce shear waves for evaluating the mechanical properties of biological tissues. Two shear waves can be generated when exciting with ARF: a transverse shear wave, also simply called shear wave (SW), and a longitudinal shear wave (LSW). Shear waves (SWs) have been broadly used to assess the mechanical properties. Some articles have reported that the LSW can be used to evaluate mechanical properties locally. However, existing LSW studies are mainly focused on the group velocity evaluation using optical coherence tomography (OCT). Here, we report that a LSW generated with ARF can be used to probe viscoelastic properties, including shear modulus and viscosity, using ultrasound. We took advantage of the surface boundary effect to reflect the LSW, named RLSW, to address the energy deficiency of LSW induced by ARF. We systematically evaluated the experiments with tissue-mimicking viscoelastic phantoms and validated by numerical simulations. Phase velocity and dispersion comparison between the results induced by a RLSW and a SW exhibit good agreement in both the numerical simulations and experimental results. The Kelvin-Voigt (KV) model was used to determine the shear modulus and viscosity. RLSW shows great potential to evaluate localized viscoelastic properties, which could benefit various biomedical applications such as evaluating the viscoelasticity of heterogeneous materials or microscopic lesions of tissues.
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Affiliation(s)
- Hsiao-Chuan Liu
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | | | - Matthew W Urban
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | - Qifa Zhou
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90033, USA
| | - Piotr Kijanka
- Department of Robotics and Mechatronics, AGH University of Krakow, Krakow 30059, Poland
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2
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Zhou R, Ding A, Lyu D, Wang C, Wang D. Shear Wave Elastography for Assessment of Changes in Abdominal Soft Tissues after Lipoabdominoplasty. Aesthetic Plast Surg 2024; 48:2668-2676. [PMID: 38148358 DOI: 10.1007/s00266-023-03794-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 12/04/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND The changes in the elasticity of the abdominal skin, subcutaneous tissues and muscles after lipoabdominoplasty are still unknown. The aim of this study was to provide an objective assessment of tissue elasticity after lipoabdominoplasty using ultrasound elastography. METHODS A total of 21 female patients (31-41 years old) who underwent lipoabdominoplasty from Oct 2019 to Mar 2022 were included in this retrospective study. The elastography values of the skin, subcutaneous tissues and abdominal muscles were obtained with the ultrasound shear wave elasticity imaging system pre-operation (Pre) and 6 months post-operation (Post) at four different points. RESULTS Twenty-one female patients were included. The elasticity of the abdominal skin, subcutaneous tissues, rectus abdominis and external oblique abdominis significantly increased at 6 months post-operation. The improvements in abdominal soft tissue elasticity were not uniform across the examined points. CONCLUSIONS Significant changes in the elasticity of the abdominal skin, subcutaneous tissues and muscles were observed after lipoabdominoplasty. Ultrasound elastographic assessment was objective and feasible for evaluating the effect of lipoabdominoplasty on abdominal soft tissue. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Renpeng Zhou
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, People's Republic of China
| | - Angang Ding
- Department of Ultrasonography, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China
| | - Dongze Lyu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, People's Republic of China
| | - Chen Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, People's Republic of China.
| | - Danru Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, People's Republic of China.
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Cihan A, Holko K, Wei L, Vos HJ, Debbaut C, Caenen A, Segers P. Effect of interstitial fluid pressure on shear wave elastography: an experimental and computational study. Phys Med Biol 2024; 69:075001. [PMID: 38412537 DOI: 10.1088/1361-6560/ad2d80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/27/2024] [Indexed: 02/29/2024]
Abstract
Objective. An elevated interstitial fluid pressure (IFP) can lead to strain-induced stiffening of poroelastic biological tissues. As shear wave elastography (SWE) measures functional tissue stiffness based on the propagation speed of acoustically induced shear waves, the shear wave velocity (SWV) can be used as an indirect measurement of the IFP. The underlying biomechanical principle for this stiffening behavior with pressurization is however not well understood, and we therefore studied how IFP affects SWV through SWE experiments and numerical modeling.Approach. For model set-up and verification, SWE experiments were performed while dynamically modulating IFP in a chicken breast. To identify the confounding factors of the SWV-IFP relationship, we manipulated the material model (linear poroelastic versus porohyperelastic), deformation assumptions (geometric linearity versus nonlinearity), and boundary conditions (constrained versus unconstrained) in a finite element model mimicking the SWE experiments.Main results. The experiments demonstrated a statistically significant positive correlation between the SWV and IFP. The model was able to reproduce a similar SWV-IFP relationship by considering an unconstrained porohyperelastic tissue. Material nonlinearity was identified as the primary factor contributing to this relationship, whereas geometric nonlinearity played a smaller role. The experiments also highlighted the importance of the dynamic nature of the pressurization procedure, as indicated by a different observed SWV-IFP for pressure buildup and relaxation, but its clinical relevance needs to be further investigated.Significance. The developed model provides an adaptable framework for SWE of poroelastic tissues and paves the way towards non-invasive measurements of IFP.
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Affiliation(s)
- Ariana Cihan
- Institute of Biomedical Engineering and Technology, Ghent University, Ghent, Belgium
| | - Kristyna Holko
- Institute of Biomedical Engineering and Technology, Ghent University, Ghent, Belgium
- Department of Structural Engineering, Norwegian University of Science and Technology, Trondheim, Norway
| | - Luxi Wei
- Cardiovascular Institute, Thorax Center, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Hendrik J Vos
- Cardiovascular Institute, Thorax Center, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Charlotte Debbaut
- Institute of Biomedical Engineering and Technology, Ghent University, Ghent, Belgium
| | - Annette Caenen
- Institute of Biomedical Engineering and Technology, Ghent University, Ghent, Belgium
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Patrick Segers
- Institute of Biomedical Engineering and Technology, Ghent University, Ghent, Belgium
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Caenen A, Bézy S, Pernot M, Nightingale KR, Vos HJ, Voigt JU, Segers P, D'hooge J. Ultrasound Shear Wave Elastography in Cardiology. JACC Cardiovasc Imaging 2024; 17:314-329. [PMID: 38448131 DOI: 10.1016/j.jcmg.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 11/14/2023] [Accepted: 12/07/2023] [Indexed: 03/08/2024]
Abstract
The advent of high-frame rate imaging in ultrasound allowed the development of shear wave elastography as a noninvasive alternative for myocardial stiffness assessment. It measures mechanical waves propagating along the cardiac wall with speeds that are related to stiffness. The use of cardiac shear wave elastography in clinical studies is increasing, but a proper understanding of the different factors that affect wave propagation is required to correctly interpret results because of the heart's thin-walled geometry and intricate material properties. The aims of this review are to give an overview of the general concepts in cardiac shear wave elastography and to discuss in depth the effects of age, hemodynamic loading, cardiac morphology, fiber architecture, contractility, viscoelasticity, and system-dependent factors on the measurements, with a focus on clinical application. It also describes how these factors should be considered during acquisition, analysis, and reporting to ensure an accurate, robust, and reproducible measurement of the shear wave.
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Affiliation(s)
- Annette Caenen
- Institute for Biomedical Engineering and Technology, Ghent University, Ghent, Belgium; Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Stéphanie Bézy
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Mathieu Pernot
- Physics for Medicine, INSERM, CNRS, ESPCI, PSL University, Paris, France
| | | | - Hendrik J Vos
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Jens-Uwe Voigt
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium.
| | - Patrick Segers
- Institute for Biomedical Engineering and Technology, Ghent University, Ghent, Belgium
| | - Jan D'hooge
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
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Malik A, Villalobos Lizardi JC, Baranger J, Venet M, Pernot M, Mital S, Nguyen MB, Chaturvedi R, Mertens L, Villemain O. Comparison Between Acoustic Radiation Force-Induced and Natural Wave Velocities for Myocardial Stiffness Assessment in Hypertrophic Cardiomyopathy. JACC Cardiovasc Imaging 2024; 17:223-225. [PMID: 37737792 DOI: 10.1016/j.jcmg.2023.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 09/23/2023]
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Caenen A, Keijzer L, Bézy S, Duchenne J, Orlowska M, Van Der Steen AFW, De Jong N, Bosch JG, Voigt JU, D'hooge J, Vos HJ. Continuous shear wave measurements for dynamic cardiac stiffness evaluation in pigs. Sci Rep 2023; 13:17660. [PMID: 37848474 PMCID: PMC10582168 DOI: 10.1038/s41598-023-44588-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/10/2023] [Indexed: 10/19/2023] Open
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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Affiliation(s)
- Annette Caenen
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
- Cardiovascular Imaging and Dynamics Lab, KU Leuven, Leuven, Belgium.
- Institute for Biomedical Engineering and Technology, Ghent University, Ghent, Belgium.
| | - Lana Keijzer
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Stéphanie Bézy
- Cardiovascular Imaging and Dynamics Lab, KU Leuven, Leuven, Belgium
| | - Jürgen Duchenne
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Marta Orlowska
- Cardiovascular Imaging and Dynamics Lab, KU Leuven, Leuven, Belgium
| | | | - Nico De Jong
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Johan G Bosch
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | | | - Jan D'hooge
- Cardiovascular Imaging and Dynamics Lab, KU Leuven, Leuven, Belgium
| | - Hendrik J Vos
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
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Lunkenheimer PP, Hagendorff A, Lunkenheimer JM, Gülker HK, Niederer P. Antagonism of contractile forces in left ventricular hypertrophy: a diagnostic challenge for better pathophysiological and clinical understanding. Open Heart 2023; 10:e002351. [PMID: 37827810 PMCID: PMC10582970 DOI: 10.1136/openhrt-2023-002351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/14/2023] Open
Abstract
Cardiac function is characterised by haemodynamic parameters in the clinical scenario. Due to recent development in imaging techniques, the clinicians focus on the quantitative assessment of left ventricular size, shape and motion patterns mostly analysed by echocardiography and cardiac magnetic resonance. Because of the physiologically known antagonistic structure and function of the heart muscle, the effective performance of the heart remains hidden behind haemodynamic parameters. In fact, a smaller component of oblique transmural netting of cardiac muscle fibres simultaneously engenders contracting and dilating force vectors, while the predominant mass of the tangentially aligned fibres only acts in one direction. In case of hypertrophy, an increased influence of the dilating transmural fibre component might counteract systolic wall thickening, thereby counteract cardiac output. A further important aspect is the response to inotropic stimulation that is different for the tangentially aligned fibre component in comparison to the transmural component. Both aspects highlight the importance to integrate the analysis of intramural fibre architecture into the clinical cardiac diagnostics.
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Affiliation(s)
- Paul Peter Lunkenheimer
- Department of Experimental Thoracic, Cardiac and Vascular Surgery, University of Münster, Münster, Germany
| | | | | | - Hartmut Karl Gülker
- Department of Cardiology, HELIOS University Hospital Wuppertal, Wuppertal, Nordrhein-Westfalen, Germany
| | - Peter Niederer
- Institute of Biomedical Engineering, University and ETH (Eidgenössische Technische Hochschule), Zürich, Switzerland
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Petrescu A, Voigt JU. [Echocardiography with high frame rates in the clinical practice : Principles, applications and perspectives]. Herz 2023; 48:339-351. [PMID: 37530782 DOI: 10.1007/s00059-023-05199-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2023] [Indexed: 08/03/2023]
Abstract
Continuous developments in cardiovascular imaging, software and hardware have led to technological advancements that open new ways for assessing myocardial mechanics, hemodynamics, and function. Through new scan modalities, echocardiographic scanners can nowadays achieve very high frame rates up to 5000 frames s-1 which enables a wide variety of new applications, including shear wave elastography, ultrafast speckle tracking, the visualization of intracardiac blood flow and myocardial perfusion imaging. This review provides an overview of these advances and demonstrates possible applications and their potential added value in the clinical practice.
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Affiliation(s)
- Aniela Petrescu
- Abteilung für Kardiologie, Universitätsmedizin Mainz, Mainz, Deutschland
| | - Jens-Uwe Voigt
- Department of Cardiology, University Hospital Leuven, University of Leuven, Herestraat 49, 3000, Leuven, Belgien.
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Smiseth OA, Donal E, Boe E, Ha JW, Fernandes JF, Lamata P. Phenotyping heart failure by echocardiography: imaging of ventricular function and haemodynamics at rest and exercise. Eur Heart J Cardiovasc Imaging 2023; 24:1329-1342. [PMID: 37542477 PMCID: PMC10531125 DOI: 10.1093/ehjci/jead196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 08/07/2023] Open
Abstract
Traditionally, congestive heart failure (HF) was phenotyped by echocardiography or other imaging techniques according to left ventricular (LV) ejection fraction (LVEF). The more recent echocardiographic modality speckle tracking strain is complementary to LVEF, as it is more sensitive to diagnose mild systolic dysfunction. Furthermore, when LV systolic dysfunction is associated with a small, hypertrophic ventricle, EF is often normal or supernormal, whereas LV global longitudinal strain can reveal reduced contractility. In addition, segmental strain patterns may be used to identify specific cardiomyopathies, which in some cases can be treated with patient-specific medicine. In HF with preserved EF (HFpEF), a diagnostic hallmark is elevated LV filling pressure, which can be diagnosed with good accuracy by applying a set of echocardiographic parameters. Patients with HFpEF often have normal filling pressure at rest, and a non-invasive or invasive diastolic stress test may be used to identify abnormal elevation of filling pressure during exercise. The novel parameter LV work index, which incorporates afterload, is a promising tool for quantification of LV contractile function and efficiency. Another novel modality is shear wave imaging for diagnosing stiff ventricles, but clinical utility remains to be determined. In conclusion, echocardiographic imaging of cardiac function should include LV strain as a supplementary method to LVEF. Echocardiographic parameters can identify elevated LV filling pressure with good accuracy and may be applied in the diagnostic workup of patients suspected of HFpEF.
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Affiliation(s)
- Otto A Smiseth
- Division of Cardiovascular and Pulmonary Diseases, Institute for Surgical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Erwan Donal
- Department of Cardiology, CHU Rennes and Inserm, LTSI, University of Rennes, Rennes, France
| | - Espen Boe
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, Oslo, Norway
| | - Jong-Won Ha
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Joao F Fernandes
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Pablo Lamata
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
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Telle Å, Bargellini C, Chahine Y, Del Álamo JC, Akoum N, Boyle PM. Personalized biomechanical insights in atrial fibrillation: opportunities & challenges. Expert Rev Cardiovasc Ther 2023; 21:817-837. [PMID: 37878350 PMCID: PMC10841537 DOI: 10.1080/14779072.2023.2273896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/18/2023] [Indexed: 10/26/2023]
Abstract
INTRODUCTION Atrial fibrillation (AF) is an increasingly prevalent and significant worldwide health problem. Manifested as an irregular atrial electrophysiological activation, it is associated with many serious health complications. AF affects the biomechanical function of the heart as contraction follows the electrical activation, subsequently leading to reduced blood flow. The underlying mechanisms behind AF are not fully understood, but it is known that AF is highly correlated with the presence of atrial fibrosis, and with a manifold increase in risk of stroke. AREAS COVERED In this review, we focus on biomechanical aspects in atrial fibrillation, current and emerging use of clinical images, and personalized computational models. We also discuss how these can be used to provide patient-specific care. EXPERT OPINION Understanding the connection betweenatrial fibrillation and atrial remodeling might lead to valuable understanding of stroke and heart failure pathophysiology. Established and emerging imaging modalities can bring us closer to this understanding, especially with continued advancements in processing accuracy, reproducibility, and clinical relevance of the associated technologies. Computational models of cardiac electromechanics can be used to glean additional insights on the roles of AF and remodeling in heart function.
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Affiliation(s)
- Åshild Telle
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Clarissa Bargellini
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
| | - Yaacoub Chahine
- Division of Cardiology, University of Washington, Seattle, WA, USA
| | - Juan C Del Álamo
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
- Center for Cardiovascular Biology, University of Washington, Seattle, WA, USA
| | - Nazem Akoum
- Department of Bioengineering, University of Washington, Seattle, WA, USA
- Division of Cardiology, University of Washington, Seattle, WA, USA
| | - Patrick M Boyle
- Department of Bioengineering, University of Washington, Seattle, WA, USA
- Center for Cardiovascular Biology, University of Washington, Seattle, WA, USA
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, USA
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Nguyen KD, Bonner BP, Foster AN, Sadighi M, Nguyen CT. Asynchronous magnetic resonance elastography: Shear wave speed reconstruction using noise correlation of incoherent waves. Magn Reson Med 2023; 89:990-1001. [PMID: 36300861 PMCID: PMC9792433 DOI: 10.1002/mrm.29502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE The noninvasive measurement of biological tissue elasticity is an evolving technology that enables the robust characterization of soft tissue mechanics for a wide array of biomedical engineering and clinical applications. We propose, design, and implement here a new MRI technique termed asynchronous magnetic resonance elastography (aMRE) that pushes the measurement technology toward a driverless implementation. This technique can be added to clinical MRI scanners without any additional specialized hardware. THEORY Asynchronous MRE is founded on the theory of diffuse wavefields and noise correlation previously developed in ultrasound to reconstruct shear wave speeds using seemingly incoherent wavefields. Unlike conventional elastography methods that solve an inverse problem, aMRE directly reconstructs a pixel-wise mapping of wave speed using the spatial-temporal statistics of the measured wavefield. METHODS Incoherent finger tapping served as the wave-generating source for all aMRE measurements. Asynchronous MRE was performed on a phantom using a Siemens Prismafit as an experimental validation of the theory. It was further performed on thigh muscles as a proof-of-concept implementation of in vivo imaging using a Siemens Skyra scanner. RESULTS Numerical and phantom experiments show an accurate reconstruction of wave speeds from seemingly noisy wavefields. The proof-of-concept thigh experiments also show that the aMRE protocol can reconstruct a pixel-wise mapping of wave speeds. CONCLUSION Asynchronous MRE is shown to accurately reconstruct shear wave speeds in phantom experiments and remains at the proof-of-concept stage for in vivo imaging. After further validation and improvements, it has the potential to lower both the technical and monetary barriers of entry to measuring tissue elasticity.
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Affiliation(s)
- Khoi D. Nguyen
- Cardiovascular Innovation Research Center, Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH,Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
| | - Benjamin P. Bonner
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
| | - Anna N. Foster
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
| | - Mehdi Sadighi
- Cardiovascular Innovation Research Center, Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH,Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
| | - Christopher T. Nguyen
- Cardiovascular Innovation Research Center, Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH,Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA,Department of Diagnostic Radiology Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH,Department of Cardiovascular & Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH,Corresponding author.
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12
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Malik A, Baranger J, Nguyen MB, Slorach C, Hui W, Villalobos Lizardi JC, Venet M, Friedberg MK, Mertens L, Villemain O. Impact of Ventricular Geometric Characteristics on Myocardial Stiffness Assessment Using Shear-Wave Velocity in Healthy Children and Young Adults. J Am Soc Echocardiogr 2023:S0894-7317(23)00093-7. [PMID: 36842514 DOI: 10.1016/j.echo.2023.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 12/28/2022] [Accepted: 02/07/2023] [Indexed: 02/28/2023]
Abstract
BACKGROUND Diastolic myocardial stiffness (MS) can serve as a key diagnostic parameter for congenital or acquired heart diseases. Using shear modulus and shear-wave velocity (SWV), shear-wave elastography (SWE) is an emerging ultrasound-based technique that can allow noninvasive assessment of MS. However, MS extrinsic parameters such as left ventricular geometric characteristics could affect shear-wave propagation. The aims of this study were to determine a range of normal values of MS using SWE in age groups of healthy children and young adults and to explore the impact of left ventricular geometric characteristics on SWE. METHODS Sixty healthy volunteers were recruited in the study and divided into 2 groups: neonates (0-1 months old, n = 15) and >1 month old (1 month to 45 years of age, n = 45). SWE was performed using the Verasonics Vantage systems with a phased-array ultrasound probe. The anteroseptal basal segment was assessed in two views. SWE was electrocardiographically triggered during the end-diastolic phase. Conventional echocardiography was performed to assess ventricular function and anatomy. Results are presented as stiffness values along with mean velocity measurements and SDs. Simple and multivariate linear regression analyses were performed. RESULTS For neonates, mean MS was 1.87 ± 0.79 kPa (range, 0.59-2.91 kPa; mean SWV, 1.37 ± 0.57 m/sec), with high variability and no correlation with age (P = .239). For this age group, no statistically significant correlation was found between MS and any demographic or echocardiographic parameters (P > .05). For the >1 month old group, a mean MS value of 1.67 ± 0.53 kPa was observed (range, 0.6-3 kPa; mean SWV, 1.29 ± 0.49 m/sec) for healthy volunteers. When paired for age, no sex-related difference was observed (P = .55). In univariate linear regression analysis, age (r = 0.83, P < .01), diastolic interventricular septal thickness (r = 0.72, P < .01), and left ventricular end-diastolic diameter (r = 0.67, P < .01) were the parameters with the highest correlation coefficients with MS. In a multiple linear regression analysis incorporating these three parameters as cofounding factors, age was the only statistically significant parameters (r = 0.81, P = .02). CONCLUSION Diastolic MS increases linearly in children and young adults. Diastolic MS correlates more robustly with age than with myocardial and left ventricular geometric characteristics. However, the geometry affects SWV, implying the need to determine well-established boundaries in future studies for the clinical application of SWE.
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Affiliation(s)
- Aimen Malik
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Jerome Baranger
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Minh Bao Nguyen
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Cameron Slorach
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Wei Hui
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - José Carlos Villalobos Lizardi
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Maelys Venet
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Mark K Friedberg
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Luc Mertens
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Olivier Villemain
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
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Villemain O, Pernot M. To Be, or Not to Be Diastolic: About Natural Mechanical Waves After Mitral Valve Closure. JACC. CARDIOVASCULAR IMAGING 2022; 15:2035-2037. [PMID: 36481070 DOI: 10.1016/j.jcmg.2022.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Olivier Villemain
- Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
| | - Mathieu Pernot
- Physics for Medicine, INSERM U1273, ESPCI, CNRS, PSL Research University, Paris, France
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Gillebert TC. Estimating Filling Pressures Noninvasively. JACC Cardiovasc Imaging 2022; 15:1692-1695. [DOI: 10.1016/j.jcmg.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 11/30/2022]
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