Mechanical Wave Velocities in Left Ventricular Walls in Healthy Subjects and Patients With Aortic Stenosis

Torvald Espeland; Morten S Wigen; Havard Dalen; Erik A R Berg; Tommy A Hammer; Sebastien Salles; Lasse Lovstakken; Brage H Amundsen; Svend Aakhus

doi:10.1016/j.jcmg.2023.07.009

Mechanical Wave Velocities in Left Ventricular Walls in Healthy Subjects and Patients With Aortic Stenosis

JACC Cardiovasc Imaging. 2024 Feb;17(2):111-124. doi: 10.1016/j.jcmg.2023.07.009. Epub 2023 Sep 6.

Authors

Torvald Espeland¹, Morten S Wigen², Havard Dalen³, Erik A R Berg⁴, Tommy A Hammer⁵, Sebastien Salles², Lasse Lovstakken², Brage H Amundsen⁶, Svend Aakhus⁶

Affiliations

¹ Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Clinic of Cardiology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway. Electronic address: torvald.espeland@ntnu.no.
² Centre for Innovative Ultrasound Solutions, Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
³ Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Clinic of Cardiology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Internal Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
⁴ Centre for Innovative Ultrasound Solutions, Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Clinic of Cardiology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.
⁵ Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Radiology, Clinic of Radiology and Nuclear Medicine, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.
⁶ Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Clinic of Cardiology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.

PMID: 37676209
DOI: 10.1016/j.jcmg.2023.07.009

Abstract

Background: Mechanical wave velocity (MWV) measurement is a promising method for evaluating myocardial stiffness, because these velocities are higher in patients with myocardial disease.

Objectives: Using high frame rate echocardiography and a novel method for detection of myocardial mechanical waves, this study aimed to estimate the MWVs for different left ventricular walls and events in healthy subjects and patients with aortic stenosis (AS). Feasibility and reproducibility were evaluated.

Methods: This study included 63 healthy subjects and 13 patients with severe AS. All participants underwent echocardiographic examination including 2-dimensional high frame rate recordings using a clinical scanner. Cardiac magnetic resonance was performed in 42 subjects. The authors estimated the MWVs at atrial kick and aortic valve closure in different left ventricular walls using the clutter filter wave imaging method.

Results: Mechanical wave imaging in healthy subjects demonstrated the highest feasibility for the atrial kick wave reaching >93% for all 4 examined left ventricular walls. The MWVs were higher for the inferolateral and anterolateral walls (2.2 and 2.6 m/s) compared with inferoseptal and anteroseptal walls (1.3 and 1.6 m/s) (P < 0.05) among healthy subjects. The septal MWVs at aortic valve closure were significantly higher for patients with severe AS than for healthy subjects.

Conclusions: MWV estimation during atrial kick is feasible and demonstrates higher velocities in the lateral walls, compared with septal walls. The authors propose indicators for quality assessment of the mechanical wave slope as an aid for achieving consistent measurements. The discrimination between healthy subjects and patients with AS was best for the aortic valve closure mechanical waves. (Ultrasonic Markers for Myocardial Fibrosis and Prognosis in Aortic Stenosis; NCT03422770).

Keywords: echocardiography; high frame rate imaging; left ventricle; myocardial fibrosis; myocardial stiffness; natural mechanical waves.

Publication types

Clinical Study

MeSH terms

Aortic Valve / diagnostic imaging
Aortic Valve Stenosis*
Cardiomyopathies*
Healthy Volunteers
Humans
Predictive Value of Tests
Reproducibility of Results
Ventricular Function, Left

Associated data

ClinicalTrials.gov/NCT03422770