The dependence of ultrasonic attenuation and backscatter on collagen content in dog and rabbit hearts.

Mimbs, James W.; O’Donnell, Matthew; Bauwens, Deborah; Miller, J.; Sobel, Burton E.

doi:10.1161/01.res.47.1.49

Cited by 187 publications

(84 citation statements)

References 24 publications

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“…Specifically, in dog and rabbit hearts Mimbs et al. 4' found that integrated ultrasonic backscatter was increased in fibrotic myocardium. Since measurements of ultrasonic backscatter may be obtained through the intact chest,6 noninvasive detection of myocardial fibrosis in patients might be possible as well.…”

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confidence: 98%

Assessment of fibrosis in infarcted human hearts by analysis of ultrasonic backscatter.

Hoyt¹,

Collins²,

Skorton³

et al. 1985

Circulation

104

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In animal hearts, the magnitude of integrated ultrasonic backscatter is increased in fibrotic myocardium. Our purpose in this study was to quantitate the relationship between ultrasonic backscatter and collagen deposition in 10 excised human hearts with old infarcts. A 2.25 MHz, 50% fractional bandwidth transducer was positioned at the transducer focal distance from the epicardium of each specimen. The radio frequency backscatter signal was digitized, squared, and integrated to yield the integrated ultrasonic backscatter, which was referenced to the backscatter from a water/steel interface. The interrogated myocardium was then excised and divided into two portions. One portion was assayed for hydroxyproline, a marker for collagen. A second portion was sectioned, stained with Masson's trichrome, and studied with the use of a computer-assisted image analysis system. There was a linear correlation between the magnitude of integrated backscatter and myocardial collagen content estimated by hydroxyproline assay (r = .78). Quantitative histologic analysis revealed a variable relationship between the transmural distribution of collagen and the corresponding transmural pattern of the backscatter signal. In two specimens exhibiting a discrete layer of subendocardial fibrosis, the backscatter amplitude was also increased in the subendocardial region. In specimens with other patterns of fibrosis, the local backscatter amplitude did not correspond to the transmural pattern of collagen distribution. We conclude that the quantitative analysis of ultrasonic backscatter shows promise for the noninvasive evaluation of myocardial fibrosis after infarction.

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confidence: 98%

Assessment of fibrosis in infarcted human hearts by analysis of ultrasonic backscatter.

Hoyt¹,

Collins²,

Skorton³

et al. 1985

Circulation

104

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“…Experimental studies have suggested that integrated backscatter (IBS) measures may be related to myocardial collagen content (11)(12)(13)(14). In humans, ultrasonic backscatter indices have been shown to be related to myocardial collagen content as assessed by endomyocardial biopsy (15)(16)(17)(18).…”

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confidence: 99%

Myocardial Ultrasound Tissue Characterization in Patients with Chronic Renal Failure

Salvetti¹,

Muiesan²,

Paini³

et al. 2007

Journal of the American Society of Nephrology

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The objective of this study was to detect ultrastructural changes in myocardium related to collagen content by ultrasound tissue characterization in patients with chronic kidney disease (CKD) and in uncomplicated hypertensive control subjects. In 25 hemodialysis (HD) patients, in 25 patients with moderate to severe chronic renal failure (CRF), and in 10 patients with essential hypertension (EH) and normal renal function matched for age, BP, and left ventricular mass index, left ventricular anatomy and function were evaluated by conventional echocardiography, and integrated backscatter signal (IBS) was analyzed by acoustic densitometry. IBS mean reflectivity increased from 48% in patients with EH to 56% in patients with CRF to 62% in HD patients (ANOVA P < 0.01). IBS mean cyclic variation was progressively increased from 4.35 ؎ 1.2 dB in HD patients to 5.27 ؎ 0.90 in patients with CRF to 6.50 ؎ 1.6 dB in patients with EH (ANOVA P < 0.01). At multivariate analysis, IBS mean reflectivity was positively related to age and serum creatinine (␤ 0.351, P ‫؍‬ 0.036; and ␤ ‫؍‬ 0.408, P ‫؍‬ 0.016, respectively). IBS mean cyclic variation was inversely related to age and serum creatinine (␤ ‫؍‬ ؊0.274, P ‫؍‬ 0.025; and ␤ ‫؍‬ ؊0.262, P ‫؍‬ 0.025, respectively) and positively related to left ventricular midwall fractional shortening and transmitral E/A ratio (␤ ‫؍‬ 0.269, P < 0.05; and ␤ ‫؍‬ 0.314, P < 0.001, respectively). The data support the hypothesis that interstitial collagen deposition may appear early in the course of CKD and suggest that acoustic densitometry may represent a useful tool for the assessment of myocardial tissue changes in patients with CKD. 18: 195318: -195818: , 200718: . doi: 10.1681 L eft ventricular hypertrophy (LVH) is an independent predictor of cardiovascular morbidity and mortality in patients with ESRD as well as in hypertensive patients, in patients with coronary artery disease, and in the general population (1). It has been demonstrated that changes in LV mass index (LVMI) over time are associated with cardiovascular prognosis (2-4), and LVH is currently considered an important intermediate end point in the treatment of hypertensive patients (5,6). A greater prevalence of LVH has been reported in patients with chronic renal failure (CRF) (7), possibly contributing to the greater risk for cardiovascular events in these patients (8,9). Experimental studies have demonstrated that the typical changes in uremic cardiomyopathy are increased cardiac size, interstitial and perivascular fibrosis, reduced capillary density, and thickening of intramural myocardial arterioles (10). J Am Soc NephrolAcoustic densitometry is a noninvasive tool for the evaluation of myocardial tissue characteristics and provides an integrated on-line capability to measure, display, and analyze the average acoustic image intensity within a user-specified region of interest (ROI). Experimental studies have suggested that integrated backscatter (IBS) measures may be related to myocardial collagen content (11)(12)(13)(14). I...

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“…20 The extracellular matrix has been shown to represent an important source of myocardial IBS, 21 and several experimental studies have demonstrated that IBS in diastole correlates with the collagen content within the myocardium. 20,22,23 Therefore, this tech-nique can be expected to provide noninvasively a relative estimate of myocardial fibrosis in humans. IBS values are highest when the insonifying ultrasound beam is perpendicular to the predominant fiber orientation.…”

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Myocardial Ultrasonic Backscatter in Hypertension

et al. 2003

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Abstract-A disproportionate accumulation of fibrillar collagen is a characteristic feature of hypertensive heart disease, but the extent of myocardial fibrosis may differ in different models of hypertension. In experimental studies, aldosterone and endothelins emerge as important determinants of myocardial fibrosis. Changes in myocardial extracellular matrix and collagen deposition can be estimated noninvasively by analysis of the ultrasonic backscatter signal, which arises from tissue heterogeneity within the myocardium and describes myocardial texture. This study was designed to investigate the relations between myocardial integrated backscatter and circulating aldosterone and immunoreactive endothelin in human hypertension. The study population consisted of 56 subjects: 14 healthy normotensive volunteers and 42 hypertensive patients (14 with primary aldosteronism, 7 with renovascular hypertension, and 21 with essential hypertension). The patients with essential and secondary hypertension were matched for age, gender, body mass index, and blood pressure. Myocardial integrated backscatter at diastole was 19.8Ϯ2.0 and 20.8Ϯ2.9 decibels in normotensive control subjects and patients with essential hypertension and significantly higher in patients with primary aldosteronism (27.4Ϯ3.8 decibels, PϽ0.01) and renovascular hypertension (26.8Ϯ4.8 decibels, PϽ0.01). In the population as a whole, as well as in the hypertensive subpopulation, myocardial integrated backscatter was directly related to plasma aldosterone (rϭ0.73 and 0.71, PϽ0.01 for both) and immunoreactive endothelin (rϭ0.60 and 0.56, PϽ0.01 for both). The data of this study suggest that in human hypertension, circulating aldosterone and immunoreactive endothelin may induce alterations in left ventricular myocardial texture, possibly related to increased myocardial collagen content.

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The dependence of ultrasonic attenuation and backscatter on collagen content in dog and rabbit hearts.

Cited by 187 publications

References 24 publications

Assessment of fibrosis in infarcted human hearts by analysis of ultrasonic backscatter.

Assessment of fibrosis in infarcted human hearts by analysis of ultrasonic backscatter.

Myocardial Ultrasound Tissue Characterization in Patients with Chronic Renal Failure

Myocardial Ultrasonic Backscatter in Hypertension

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