Evaluation of Myocardial Stiffness in Cardiac Amyloidosis Using Acoustic Radiation Force Impulse and Natural Shear Wave Imaging.

Autor:	Jin FQ; Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA., Kakkad V; Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA. Electronic address: v.kakkad@duke.edu., Bradway DP; Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA., LeFevre M; Department of Cardiology, Duke University Medical Center, Durham, North Carolina, USA., Kisslo J; Department of Cardiology, Duke University Medical Center, Durham, North Carolina, USA., Khouri MG; Department of Cardiology, Duke University Medical Center, Durham, North Carolina, USA., Trahey GE; Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA; Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA.
Jazyk:	angličtina
Zdroj:	Ultrasound in medicine & biology [Ultrasound Med Biol] 2023 Aug; Vol. 49 (8), pp. 1719-1727. Date of Electronic Publication: 2023 May 04.
DOI:	10.1016/j.ultrasmedbio.2023.03.016
Abstrakt:	Objective: Increased myocardial stiffness (MS) is an important hallmark of cardiac amyloidosis (CA) caused by myocardial amyloid deposition. Standard echocardiography metrics assess MS indirectly via downstream effects of cardiac stiffening. The ultrasound elastography methods acoustic radiation force impulse (ARFI) and natural shear wave (NSW) imaging assess MS more directly. Methods: This study compared MS in 12 healthy volunteers and 13 patients with confirmed CA using ARFI and NSW imaging. Parasternal long-axis acquisitions of the interventricular septum were obtained using a modified Acuson Sequoia scanner and a 5V1 transducer. ARFI-induced displacements were measured through the cardiac cycle, and ratios of diastolic-over-systolic displacement were calculated. NSW speeds from aortic valve closure were extracted from echocardiography-tracked displacement data. Results: ARFI stiffness ratios were significantly lower in CA patients than controls (mean ± standard deviation: 1.47 ± 0.27 vs. 2.10 ± 0.47, p < 0.001), and NSW speeds were significantly higher in CA patients than controls (5.58 ± 1.10 m/s vs. 3.79 ± 1.10 m/s, p < 0.001). A linear combination of the two metrics exhibited greater diagnostic potential than either metric alone (area under the curve = 0.97 vs. 0.89 and 0.88). Conclusion: MS was measured to be significantly higher in CA patients using both ARFI and NSW imaging. Together, these methods have potential utility to aid in clinical diagnosis of diastolic dysfunction and infiltrative cardiomyopathies. Competing Interests: Conflict of interest J.K. is a speaker and consultant for Philips and GE. M.K. reports research support from Pfizer, Alnylam Pharmaceuticals, Eidos Therapeutics and Boston Scientific and consulting/advisory board support from Pfizer, Alnylam Pharmaceuticals and Eidos Therapeutics, and is a member of Alnylam Pharmaceuticals Speaker's Bureau. G.E.T. reports a financial interest in Samsung Inc., which is developing products related to the research described in this article; he has intellectual property in acoustic radiation force impulse (ARFI) and shear wave elasticity imaging. His laboratory at Duke University has a master research agreement with Siemens Medical Solutions USA, Inc. In this work ARFI imaging is described in an implementation that is not U.S. Food and Drug Administration cleared for clinical use. The other authors report no disclosures. (Copyright © 2023 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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