Biomechanical modeling and 3D high frame rate imaging to support ultrasound shear wave elastography for assessing stiffness in cardiac remodeling

Cardiac remodeling refers to changes in structure and function of the heart in response to cardiac disease or injury. A key parameter in the remodeling process is myocardial stiffness, which currently cannot be measured non-invasively in clinical practice. For this purpose, ultrasound shear wave elastography has shown tremendous potential, but the main question remains whether the technique is able to distinguish intrinsic stiffening (possibly non-reversible) from functional stiffening (reversible). To interpret shear wave elastography measurements with respect to its mechanical confounders, this project aims to further advance the finite element model developed in my junior FWO postdoc by accounting for the effects of contractility, viscoelasticity and a realistic natural wave excitation source (realistic cardiac morphology). Complementary to these simulations, we will perform 3D shear wave elastography measurements in healthy volunteers and patients with varying degrees of stenosis to get better insights into the natural wave physics, and subsequently put forward the preferred imaging technology (2D/3D) with optimized settings for robust and reliable results. Based on the experiments and modeling results, a new measurement protocol (with new metrics) will be proposed to pinpoint intrinsic stiffness changes. This protocol will be tested in vivo to assess its feasibility, sensitivity and robustness for myocardial stiffness assessment.