ArticleOpen heart2026
Ultrafast ultrasound shear wave elastography: a novel approach for assessing myocardial stiffening in congenital aortic stenosis.
Article in Open heart, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCongenital aortic stenosis (ConAoS) accounts for approximately 4%-8% of all congenital heart diseases. Chronic pressure overload may result in myocardial stiffening, leading to impaired cardiac filling, reduced contractility and ultimately contributing to the onset of symptomatic heart failure. Shear wave elastography (SWE), using high-frame-rate echocardiography, allows visualisation of myocardial shear waves. By measuring shear wave propagation velocity (SWV), this technique may enable non-invasive assessment of myocardial stiffness. This study aimed to explore the feasibility of SWE in adults with ConAoS and to compare SWV with healthy volunteers (HVs).
methodsIn 68 adult patients with ConAoS-including 17 patients after aortic valve replacement (AVR)-and 19 HVs, high-frame-rate recordings were acquired in the parasternal long-axis view. Custom software was used to measure SWV by manually placing M-mode lines through the interventricular septum after aortic valve closure.
resultsSWE feasibility was 73% in ConAoS patients with a native aortic valve (NV), 53% post-AVR and 100% in HVs. Median SWV was 4.7 m/s (3.2-5.5) in NV patients, 3.7 m/s (3.1-5.4) post-AVR and 3.4 m/s (3.0-4.4) in HVs (p=0.200). Patients with moderate-to-severe ConAoS demonstrated higher SWV compared with HVs (4.7 m/s (3.4-5.6) vs 3.4 m/s (3.0-4.4); p=0.035).
conclusionsSWE is feasible in the majority of ConAoS patients. Higher SWV in moderate-to-severe ConAoS patients, despite preserved diastolic function in most cases, may reflect early myocardial mechanical alterations and provide a promising non-invasive marker for myocardial stiffening. Further technical optimisation and cross-platform validation are essential for clinical translation.
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