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Arani A, Murphy MC, Bhopalwala H, Arunachalam SP, Rossman PJ, Trzasko JD, Glaser K, Sui Y, Gunderson T, Arruda-Olson AM, Manduca A, Kantarci K, Ehman RL, Araoz PA. Sex Differences in Aging-related Myocardial Stiffening Quantitatively Measured with MR Elastography. Radiol Cardiothorac Imaging 2024; 6:e230140. [PMID: 38780427 DOI: 10.1148/ryct.230140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Purpose To investigate the feasibility of using quantitative MR elastography (MRE) to characterize the influence of aging and sex on left ventricular (LV) shear stiffness. Materials and Methods In this prospective study, LV myocardial shear stiffness was measured in 109 healthy volunteers (age range: 18-84 years; mean age, 40 years ± 18 [SD]; 57 women, 52 men) enrolled between November 2018 and September 2019, using a 5-minute MRE acquisition added to a clinical MRI protocol. Linear regression models were used to estimate the association of cardiac MRI and MRE characteristics with age and sex; models were also fit to assess potential age-sex interaction. Results Myocardial shear stiffness significantly increased with age in female (age slope = 0.03 kPa/year ± 0.01, P = .009) but not male (age slope = 0.008 kPa/year ± 0.009, P = .38) volunteers. LV ejection fraction (LVEF) increased significantly with age in female volunteers (0.23% ± 0.08 per year, P = .005). LV end-systolic volume (LVESV) decreased with age in female volunteers (-0.20 mL/m2 ± 0.07, P = .003). MRI parameters, including T1, strain, and LV mass, did not demonstrate this interaction (P > .05). Myocardial shear stiffness was not significantly correlated with LVEF, LV stroke volume, body mass index, or any MRI strain metrics (P > .05) but showed significant correlations with LV end-diastolic volume/body surface area (BSA) (slope = -3 kPa/mL/m2 ± 1, P = .004, r2 = 0.08) and LVESV/BSA (-1.6 kPa/mL/m2 ± 0.5, P = .003, r2 = 0.08). Conclusion This study demonstrates that female, but not male, individuals experience disproportionate LV stiffening with natural aging, and these changes can be noninvasively measured with MRE. Keywords: Cardiac, Elastography, Biological Effects, Experimental Investigations, Sexual Dimorphisms, MR Elastography, Myocardial Shear Stiffness, Quantitative Stiffness Imaging, Aging Heart, Myocardial Biomechanics, Cardiac MRE Supplemental material is available for this article. Published under a CC BY 4.0 license.
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Affiliation(s)
- Arvin Arani
- From the Departments of Radiology (A.A., M.C.M., H.B., S.P.A., P.J.R., J.D.T., K.G., Y.S., A.M., K.K., R.L.E., P.A.A.), Quantitative Health Science (T.G.), and Cardiology (A.M.A.O.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Matthew C Murphy
- From the Departments of Radiology (A.A., M.C.M., H.B., S.P.A., P.J.R., J.D.T., K.G., Y.S., A.M., K.K., R.L.E., P.A.A.), Quantitative Health Science (T.G.), and Cardiology (A.M.A.O.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Huzefa Bhopalwala
- From the Departments of Radiology (A.A., M.C.M., H.B., S.P.A., P.J.R., J.D.T., K.G., Y.S., A.M., K.K., R.L.E., P.A.A.), Quantitative Health Science (T.G.), and Cardiology (A.M.A.O.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Shivaram P Arunachalam
- From the Departments of Radiology (A.A., M.C.M., H.B., S.P.A., P.J.R., J.D.T., K.G., Y.S., A.M., K.K., R.L.E., P.A.A.), Quantitative Health Science (T.G.), and Cardiology (A.M.A.O.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Phillip J Rossman
- From the Departments of Radiology (A.A., M.C.M., H.B., S.P.A., P.J.R., J.D.T., K.G., Y.S., A.M., K.K., R.L.E., P.A.A.), Quantitative Health Science (T.G.), and Cardiology (A.M.A.O.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Joshua D Trzasko
- From the Departments of Radiology (A.A., M.C.M., H.B., S.P.A., P.J.R., J.D.T., K.G., Y.S., A.M., K.K., R.L.E., P.A.A.), Quantitative Health Science (T.G.), and Cardiology (A.M.A.O.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Kevin Glaser
- From the Departments of Radiology (A.A., M.C.M., H.B., S.P.A., P.J.R., J.D.T., K.G., Y.S., A.M., K.K., R.L.E., P.A.A.), Quantitative Health Science (T.G.), and Cardiology (A.M.A.O.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Yi Sui
- From the Departments of Radiology (A.A., M.C.M., H.B., S.P.A., P.J.R., J.D.T., K.G., Y.S., A.M., K.K., R.L.E., P.A.A.), Quantitative Health Science (T.G.), and Cardiology (A.M.A.O.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Tina Gunderson
- From the Departments of Radiology (A.A., M.C.M., H.B., S.P.A., P.J.R., J.D.T., K.G., Y.S., A.M., K.K., R.L.E., P.A.A.), Quantitative Health Science (T.G.), and Cardiology (A.M.A.O.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Adelaide M Arruda-Olson
- From the Departments of Radiology (A.A., M.C.M., H.B., S.P.A., P.J.R., J.D.T., K.G., Y.S., A.M., K.K., R.L.E., P.A.A.), Quantitative Health Science (T.G.), and Cardiology (A.M.A.O.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Armando Manduca
- From the Departments of Radiology (A.A., M.C.M., H.B., S.P.A., P.J.R., J.D.T., K.G., Y.S., A.M., K.K., R.L.E., P.A.A.), Quantitative Health Science (T.G.), and Cardiology (A.M.A.O.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Kejal Kantarci
- From the Departments of Radiology (A.A., M.C.M., H.B., S.P.A., P.J.R., J.D.T., K.G., Y.S., A.M., K.K., R.L.E., P.A.A.), Quantitative Health Science (T.G.), and Cardiology (A.M.A.O.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Richard L Ehman
- From the Departments of Radiology (A.A., M.C.M., H.B., S.P.A., P.J.R., J.D.T., K.G., Y.S., A.M., K.K., R.L.E., P.A.A.), Quantitative Health Science (T.G.), and Cardiology (A.M.A.O.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Philip A Araoz
- From the Departments of Radiology (A.A., M.C.M., H.B., S.P.A., P.J.R., J.D.T., K.G., Y.S., A.M., K.K., R.L.E., P.A.A.), Quantitative Health Science (T.G.), and Cardiology (A.M.A.O.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
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Caenen A, Bézy S, Pernot M, Nightingale KR, Vos HJ, Voigt JU, Segers P, D'hooge J. Ultrasound Shear Wave Elastography in Cardiology. JACC Cardiovasc Imaging 2024; 17:314-329. [PMID: 38448131 DOI: 10.1016/j.jcmg.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 11/14/2023] [Accepted: 12/07/2023] [Indexed: 03/08/2024]
Abstract
The advent of high-frame rate imaging in ultrasound allowed the development of shear wave elastography as a noninvasive alternative for myocardial stiffness assessment. It measures mechanical waves propagating along the cardiac wall with speeds that are related to stiffness. The use of cardiac shear wave elastography in clinical studies is increasing, but a proper understanding of the different factors that affect wave propagation is required to correctly interpret results because of the heart's thin-walled geometry and intricate material properties. The aims of this review are to give an overview of the general concepts in cardiac shear wave elastography and to discuss in depth the effects of age, hemodynamic loading, cardiac morphology, fiber architecture, contractility, viscoelasticity, and system-dependent factors on the measurements, with a focus on clinical application. It also describes how these factors should be considered during acquisition, analysis, and reporting to ensure an accurate, robust, and reproducible measurement of the shear wave.
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Affiliation(s)
- Annette Caenen
- Institute for Biomedical Engineering and Technology, Ghent University, Ghent, Belgium; Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Stéphanie Bézy
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Mathieu Pernot
- Physics for Medicine, INSERM, CNRS, ESPCI, PSL University, Paris, France
| | | | - Hendrik J Vos
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Jens-Uwe Voigt
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium.
| | - Patrick Segers
- Institute for Biomedical Engineering and Technology, Ghent University, Ghent, Belgium
| | - Jan D'hooge
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
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Nguyen KD, Bonner BP, Foster AN, Sadighi M, Nguyen CT. Asynchronous magnetic resonance elastography: Shear wave speed reconstruction using noise correlation of incoherent waves. Magn Reson Med 2023; 89:990-1001. [PMID: 36300861 PMCID: PMC9792433 DOI: 10.1002/mrm.29502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE The noninvasive measurement of biological tissue elasticity is an evolving technology that enables the robust characterization of soft tissue mechanics for a wide array of biomedical engineering and clinical applications. We propose, design, and implement here a new MRI technique termed asynchronous magnetic resonance elastography (aMRE) that pushes the measurement technology toward a driverless implementation. This technique can be added to clinical MRI scanners without any additional specialized hardware. THEORY Asynchronous MRE is founded on the theory of diffuse wavefields and noise correlation previously developed in ultrasound to reconstruct shear wave speeds using seemingly incoherent wavefields. Unlike conventional elastography methods that solve an inverse problem, aMRE directly reconstructs a pixel-wise mapping of wave speed using the spatial-temporal statistics of the measured wavefield. METHODS Incoherent finger tapping served as the wave-generating source for all aMRE measurements. Asynchronous MRE was performed on a phantom using a Siemens Prismafit as an experimental validation of the theory. It was further performed on thigh muscles as a proof-of-concept implementation of in vivo imaging using a Siemens Skyra scanner. RESULTS Numerical and phantom experiments show an accurate reconstruction of wave speeds from seemingly noisy wavefields. The proof-of-concept thigh experiments also show that the aMRE protocol can reconstruct a pixel-wise mapping of wave speeds. CONCLUSION Asynchronous MRE is shown to accurately reconstruct shear wave speeds in phantom experiments and remains at the proof-of-concept stage for in vivo imaging. After further validation and improvements, it has the potential to lower both the technical and monetary barriers of entry to measuring tissue elasticity.
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Affiliation(s)
- Khoi D. Nguyen
- Cardiovascular Innovation Research Center, Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH,Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
| | - Benjamin P. Bonner
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
| | - Anna N. Foster
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
| | - Mehdi Sadighi
- Cardiovascular Innovation Research Center, Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH,Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
| | - Christopher T. Nguyen
- Cardiovascular Innovation Research Center, Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH,Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA,Department of Diagnostic Radiology Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH,Department of Cardiovascular & Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH,Corresponding author.
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