Skip to main content
Journal cover image

Non-invasive Measurement of Dynamic Myocardial Stiffness Using Acoustic Radiation Force Impulse Imaging.

Publication ,  Journal Article
Kakkad, V; LeFevre, M; Hollender, P; Kisslo, J; Trahey, GE
Published in: Ultrasound Med Biol
May 2019

Myocardial stiffness exhibits cyclic variations over the course of the cardiac cycle. These trends are closely tied to the electromechanical and hemodynamic changes in the heart. Characterization of dynamic myocardialstiffness can provide insights into the functional state of the myocardium, as well as allow for differentiation between the underlying physiologic mechanisms that lead to congestive heart failure. Previous work has revealed the potential of acoustic radiation force impulse (ARFI) imaging to capture temporal trends in myocardial stiffness in experimental preparations such as the Langendorff heart, as well as on animals in open-chest and intracardiac settings. This study was aimed at investigating the potential of ARFI to measure dynamic myocardial stiffness in human subjects, in a non-invasive manner through transthoracic imaging windows. ARFI imaging was performed on 12 healthy volunteers to track stiffness changes within the interventricular septum in parasternal long-axis and short-axis views. Myocardial stiffness dynamics over the cardiac cycle was quantified using five indices: stiffness ratio, rates of relaxation and contraction and time constants of relaxation and contraction. The yield of ARFI acquisitions was evaluated based on metrics of signal strength and tracking fidelity such as displacement signal-to-noise ratio, signal-to-clutter level, temporal coherence of speckle and spatial similarity within the region of excitation. These were quantified using the mean ARF-induced displacements over the cardiac cycle, the contrast between the myocardium and the cardiac chambers, the minimum correlation coefficients of radiofrequency signals and the correlation between displacement traces across simultaneously acquired azimuthal beams, respectively. Forty-one percent of ARFI acquisitions were determined to be "successful" using a mean ARF-induced displacement threshold of 1.5 μm. "Successful" acquisitions were found to have higher (i) signal-to-clutter levels, (ii) temporal coherence and (iii) spatial similarity compared with "unsuccessful" acquisitions. Median values of these three metrics, between the two groups, were measured to be 13.42dB versus 5.42dB, 0.988 versus 0.976 and 0.984 versus 0.849, respectively. Signal-to-clutter level, temporal coherence and spatial similarity were also found to correlate with each other. Across the cohort of healthy volunteers, the stiffness ratio measured was 2.74 ± 0.86; the rate of relaxation, 7.82 ± 4.69/s; and the rate of contraction, -7.31±3.79 /s. The time constant of relaxation was 35.90 ± 20.04ms, and that of contraction was 37.24 ± 19.85ms. ARFI-derived indices of myocardial stiffness were found to be similar in both views. These results indicate the feasibility of using ARFI to measure dynamic myocardial stiffness trends in a non-invasive manner and also highlightthe technical challenges of implementing this method in the transthoracic imaging environment.

Duke Scholars

Published In

Ultrasound Med Biol

DOI

EISSN

1879-291X

Publication Date

May 2019

Volume

45

Issue

5

Start / End Page

1112 / 1130

Location

England

Related Subject Headings

  • Young Adult
  • Reproducibility of Results
  • Reference Values
  • Image Processing, Computer-Assisted
  • Humans
  • Heart
  • Feasibility Studies
  • Elasticity Imaging Techniques
  • Adult
  • Acoustics
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kakkad, V., LeFevre, M., Hollender, P., Kisslo, J., & Trahey, G. E. (2019). Non-invasive Measurement of Dynamic Myocardial Stiffness Using Acoustic Radiation Force Impulse Imaging. Ultrasound Med Biol, 45(5), 1112–1130. https://doi.org/10.1016/j.ultrasmedbio.2018.12.011
Kakkad, Vaibhav, Melissa LeFevre, Peter Hollender, Joseph Kisslo, and Gregg E. Trahey. “Non-invasive Measurement of Dynamic Myocardial Stiffness Using Acoustic Radiation Force Impulse Imaging.Ultrasound Med Biol 45, no. 5 (May 2019): 1112–30. https://doi.org/10.1016/j.ultrasmedbio.2018.12.011.
Kakkad V, LeFevre M, Hollender P, Kisslo J, Trahey GE. Non-invasive Measurement of Dynamic Myocardial Stiffness Using Acoustic Radiation Force Impulse Imaging. Ultrasound Med Biol. 2019 May;45(5):1112–30.
Kakkad, Vaibhav, et al. “Non-invasive Measurement of Dynamic Myocardial Stiffness Using Acoustic Radiation Force Impulse Imaging.Ultrasound Med Biol, vol. 45, no. 5, May 2019, pp. 1112–30. Pubmed, doi:10.1016/j.ultrasmedbio.2018.12.011.
Kakkad V, LeFevre M, Hollender P, Kisslo J, Trahey GE. Non-invasive Measurement of Dynamic Myocardial Stiffness Using Acoustic Radiation Force Impulse Imaging. Ultrasound Med Biol. 2019 May;45(5):1112–1130.
Journal cover image

Published In

Ultrasound Med Biol

DOI

EISSN

1879-291X

Publication Date

May 2019

Volume

45

Issue

5

Start / End Page

1112 / 1130

Location

England

Related Subject Headings

  • Young Adult
  • Reproducibility of Results
  • Reference Values
  • Image Processing, Computer-Assisted
  • Humans
  • Heart
  • Feasibility Studies
  • Elasticity Imaging Techniques
  • Adult
  • Acoustics