Shear wave imaging ‘extremely promising’ for assessment of myocardial stiffness in heart transplant recipients

Shear wave (SW) elastography may provide value in the assessment of myocardial stiffness after a heart transplant, according to new findings presented at ESC Congress 2020.

The noninvasive imaging technique shows potential where cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement falls short.   

The study, published in JACC: Cardiovascular Imaging, examined 46 heart transplant recipients who received routine follow-up treatment at a single facility from May 2018 to February 2019. All patients underwent standard echocardiography, echocardiography shear wave imaging and right heart catherization within 24 hours. Diffuse myocardial injury was quantified using T1 mapping. Recent CMR data was available for 23 patients, and the time from echocardiography to CMR was approximately four months.  

The authors detected myocardial SWs after mitral valve closure in 91% of patients, correlating well with native myocardial T1values. Standard echocardiographic parameters of left ventricular diastolic function, the team added, “correlated poorly” with native t1 values and pulmonary capillary wedge pressures.

“A single non-invasive parameter to assess ventricular stiffness as supposed mechanism of diastolic function in hear transplant recipients with evidence of diffuse myocardial injury has not been previously reported,” wrote lead author Aniela Petrescu, MD, department of cardiovascular sciences at the University of Leuven in Belgium, and colleagues. “Still today, estimation of diastolic function in this group of patients is based on invasive measurements. Shear wave imaging is an extremely promising approach, and additional studies are needed to clarify if this parameter could improve the diagnosis and prognosis of this population.”

ESC Congress 2020 is completely digital due to the ongoing COVID-19 pandemic. More information from the European Society of Cardiology is available here.