Is myocardial fibrosis appropriately assessed by calibrated and 2D strain derived integrated backscatter?

IF 1.9 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Ultrasound Pub Date : 2023-08-12 DOI:10.1186/s12947-023-00311-x

Maria Rita Lima, João Abecasis, Rita Reis Santos, Sérgio Maltês, Pedro Lopes, António Ferreira, Regina Ribeiras, Maria João Andrade, Miguel Abecasis, Victor Gil, Sância Ramos, Nuno Cardim

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引用次数: 0

Abstract

Aims: Increased collagen content of the myocardium modifies tissue reflectivity and integrated backscatter (IBS) indexes are suggested as markers of myocardial fibrosis (MF). We sought to assess the correlation between calibrated (c) IBS and bidimensional (2D) strain derived IBS with left ventricular (LV) MF in patients with severe aortic stenosis (AS).

Methods and results: We made a prospective observational cohort study including 157 patients with severe AS referred for surgical aortic valve replacement (AVR), with complete preoperative transthoracic echocardiography, cardiac magnetic resonance (CMR) and endomyocardial biopsy (EMB) obtained from the anterior basal septum at the time of surgery. Two groups of 30 patients were specifically evaluated, with and without late gadolinium enhancement (LGE) at CMR. IBS was obtained at QRS peak from both parasternal long axis (PLAX) and apical-three-chamber (AP3C) views and measured in decibels (dB). Whole-cardiac cycle IBS at basal anterior septum was obtained from 2D longitudinal strain. Correlation analysis of reflectivity indexes was performed with global and segmental (anterior basal septum) values of native T1 and extracellular volume (ECV), and EMB collagen volume fraction (CVF) (Masson´s Trichrome). IBS values were compared in both group of patients (LGE + vs. LGE -). 60 patients (74 [36-74] years, 45% male) with high gradient (mean gradient: 63 ± 20mmHg), normal flow (45 ± 10mL/m²) AS and preserved left ventricular ejection fraction (60 ± 9%) were included. Basal septum cIBS was - 17.45 (-31.2-10.95) and - 9.17 ± 9.45dB from PLAX and A3C views, respectively. No significant correlations were found between IBS and both non-invasive CMR tissue characterization and CVF: median MF of 9.7(2.1-79.9)%. Acoustic indexes were not significantly different according to the presence of pre-operative LGE.

Conclusion: In this group of patients with classical severe AS, IBS reflectivity indexes are of no added value to discriminate the presence of MF.

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心肌纤维化是否可以通过校准和二维应变衍生的综合后向散射来评估?

目的:心肌胶原含量的增加改变了组织反射率和综合后向散射(IBS)指数作为心肌纤维化(MF)的标志。我们试图评估严重主动脉狭窄(AS)患者校准(c) IBS和二维(2D)菌株衍生IBS与左室(LV) MF之间的相关性。方法和结果:我们进行了一项前瞻性观察队列研究，包括157例接受外科主动脉瓣置换术(AVR)的严重AS患者，术前进行了完整的经胸超声心动图、心脏磁共振(CMR)和手术前基底隔心内膜活检(EMB)。两组30例患者分别接受CMR晚期钆增强(LGE)和非晚期钆增强(LGE)评估。在QRS峰从胸骨旁长轴(PLAX)和顶尖三腔(AP3C)视图获得IBS，并以分贝(dB)测量。通过二维纵向应变获得基底前隔全心周期IBS。反射率指标与天然T1、细胞外体积(ECV)和EMB胶原体积分数(CVF) (Masson’s Trichrome)的整体和节段(前基底隔)值进行相关性分析。比较两组患者的IBS值(LGE + vs。lg电器-)。本研究纳入高梯度(平均梯度63±20mmHg)、血流正常(45±10mL/m2)、左室射血分数保留(60±9%)的患者60例(74[36-74]岁，男性45%)。基底隔cIBS分别为- 17.45(-31.2-10.95)和- 9.17±9.45dB。IBS与无创CMR组织特征和CVF之间没有显著相关性:中位MF为9.7(2.1- 79.9%)%。术前有无LGE的声学指标差异无统计学意义。结论:在本组典型重度AS患者中，IBS反射率指标对辨别MF的存在没有附加价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Ultrasound CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Cardiovascular Ultrasound is an online journal, publishing peer-reviewed: original research; authoritative reviews; case reports on challenging and/or unusual diagnostic aspects; and expert opinions on new techniques and technologies. We are particularly interested in articles that include relevant images or video files, which provide an additional dimension to published articles and enhance understanding. As an open access journal, Cardiovascular Ultrasound ensures high visibility for authors in addition to providing an up-to-date and freely available resource for the community. The journal welcomes discussion, and provides a forum for publishing opinion and debate ranging from biology to engineering to clinical echocardiography, with both speed and versatility.