Early Finding of diastolic heart Failure by EchoCardiographic Tissue Stiffness measurements

We propose a method for early diagnosis of stiffening of the heart, which employs non-invasive ultrasound imaging and allows early identification of (patients at risk of developing) heart failure. 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 beating heart, flowing blood, breathing, etc. The propagation velocity of the resulting natural shear waves is dependent on the local stiffness of the heart muscle. The determination of this propagation velocity and the corresponding stiffness will be a breakthrough in cardiac ultrasonic diagnosis.

Three main original steps will be taken to obtain this breakthrough. First, the realization of a very high frame rate acquisition system with high penetration depth and high spatial resolution. Second, the processing of the ultrasound data for extracting the shear waves in the heart wall and third, developing a cardiac model to relate the shear wave data to the local stiffness. We will evaluate this method in a study containing both healthy volunteers and patients in three hospital centers.

Utilization goals:

• Effective treatment, guided by accurate measurements of stiffness and diastolic function;
• Implementation of the techniques in current high-end clinical ultrasound systems, which facilitates a rapid implementation into the clinical environment;
• More information will become available on gender-specific aspects of heart failure, e.g. whether myocardial stiffness plays a different role in men and women, and what symptoms are specifically important in men and women;
• A better differentiation of the diastolic mechanics which will allow faster development and evaluation of therapies that focus on specific underlying causes or early heart failure.

Both the tests in the laboratory and in healthy volunteers and a group of patients showed that this technique works. At the moment, several groups of patients are being examined, with the central question whether early recognition of the stiffening can actually be done..