EFFECTS - Echocardiographic Tissue Stiffness measurements

Background information

Heart failure is a major public health problem in developed countries. There is a poor prognosis in patients with heart failure. Left ventricular diastolic dysfunction is one of the important underlying mechanisms, to a large extent caused by increased stiffness of the heart. Patients with predominantly diastolic dysfunction have a 1-year mortality rate of 25%. Currently, there is no accurate non-invasive method for early diagnosis of heart failure and there is no method of monitoring the therapy.

Overall aim

EFFECTS delivers a technique for early diagnosis of stiffening of the heart, which employs non-invasive ultrasound imaging. We use a very high frame rate (1000 FPS) acquisition system to capture the waves, on a clinical machine that was custom programmed for this project. The new method is based on the natural shear waves in the heart muscle, which find their origin in the natural "noise-like" mechanical excitations caused by the valve closure heart, atrial contraction, flowing blood, etc. The propagation velocity of the resulting natural shear waves is dependent on the local stiffness of the heart muscle.

Research method

The team consists of several researchers with their own specialism: data processing, imaging systems, and pre-clinical, voluntary, and clinical studies. From scratch, we will develop and test the concepts to accurately measure the stiffness.

Desirable outcome

We will test the system both in lab-settings and in patients, within and outside Erasmus MC to be able to show the benefit of the technique to recognize increased stiffness of the heart wall.

This work is part of the STW – Dutch Heart Foundation partnership program ‘Earlier recognition of cardiovascular diseases’ with project number 14740, which is (partly) financed by the Netherlands Organization for Scientific Research (NWO).

Collaborations within Erasmus MC

-department of Cardiology
-department of pediatric cardiology

Collaborations outside of Erasmus MC

-Prof. Nico de Jong and dr. Martin Verweij, Medical Imaging lab, department of Imaging Physics, Faculty of Applied Sciences, Delft University of Technology
-Prof. van der Velden, Physiology, Amsterdam Medical Center location VuMC

-“Naturally Occurring Shear Waves in Healthy Volunteers and Hypertrophic Cardiomyopathy Patients”
-“Reproducibility of Natural Shear Wave Elastography Measurements”
-“Myocardial Stretch Post-atrial Contraction in Healthy Volunteers and Hypertrophic Cardiomyopathy Patients”
-“Cardiac Shear Wave Velocity Detection in the Porcine Heart”

• Rik Vos
• Nico de Jong
• Hans Bosch
• Lana Keijzer
• Mihai Strachinaru
• Annette Caenen