3D mechanical waves trajectory reconstruction: a new 3D ultrasound imaging approach for evaluating cardiac tissue properties and remodeling

Abstract: Cardiovascular disease is a leading cause of mortality in the Western world, and fibrosis is a common pathology in cardiovascular disease. In the myocardium, fibrosis leads to electrical and mechanical dysfunction, cardiac fiber disarray, and increasing tissue stiffness, affecting both diastolic and systolic functions. Moreover, myocardial fibrosis is associated with a worsened prognosis in many disorders. Therefore, early detection of the amount of fibrosis is essential, as it could have therapeutic implications. The scientific project aims to develop and validate non-invasive and relatively inexpensive ways of assessing cardiac and vascular tissue properties (local wall stiffness, fiber orientation, and fibrosis level) in vivo in humans. Currently, there is no technique permitting the sensitive evaluation of these properties available for clinical routine. As a starting point, this ATIP Avenir Project focused on developing and validating new methods to characterize the cardiac tissue stiffness and orientation using the propagation of natural mechanical waves occurring in the left ventricle of the heart. With the advancement of 3D high frame-rate ultrasound scanners, the study of natural mechanical wave propagation for detecting cardiovascular diseases has become a major research field across the world. However, only the speed of the different mechanical waves occurring naturally in the myocardium has been studied. We developed a novel ultrasound imaging method able to quantify both tissue elasticity and tissue fibers orientations using 3D high frame-rate ultrasound imaging using the propagation of mechanical waves naturally produced by the heart. First, the proposed technique has been evaluated by simulation and experimentally. Several tissue-mimicking phantoms with local stiffness and orientation variations have been made and used for experimental validation. The feasibility of 3D mechanical wave trajectory reconstruction will then be evaluated in a preliminary clinical study involving 40 patients with mitral regurgitation at different stages. This novel technique will provide new in vivo knowledge of tissue-related cardiac physio-pathological processes. Development with ultrasound technology will furthermore provide an accessible, cost-effective, and real-time method that will be well adapted to screening and therapeutic follow-up in patients.

Le mardi 10 décembre 2024 à 14h00 / Amphithéâtre François Canac, LMA

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