TOPLINE

Shear wave velocity was successfully measured using ultrafast ultrasound in most adults with congenital aortic stenosis, and those with moderate-to-severe disease had higher shear wave velocities than healthy volunteers, suggesting myocardial stiffening.

METHODOLOGY

• Researchers assessed whether ultrafast ultrasound shear wave elastography could non-invasively measure myocardial stiffening in adults with congenital aortic stenosis.
• They prospectively included 68 adults with congenital aortic stenosis (median age, 42 years; 34% women) and 19 healthy volunteers (median age, 22 years; 58% women) between 2022 and 2023 at a tertiary centre in Netherlands; 17 patients had undergone post-aortic valve replacement and 51 had native aortic valves.
• High-frame-rate echocardiography recordings were acquired at 1000 Hz in the parasternal long-axis view, and a custom software was used to track shear waves in the interventricular septum after aortic valve closure.
• The researchers calculated shear wave velocity from multiple 1.2-second recordings, used the median of repeated measurements per patient, and compared feasibility and median shear wave velocity between patients and healthy volunteers.

TAKEAWAY

• Shear wave velocity was successfully measured in 73% of patients with native aortic valves, 53% of those with post-aortic valve replacement, and 100% of healthy volunteers.
• The feasibility of the measurement of shear wave velocity was lower in patients older in age (P < .001) and those with high BMI (P = .015).
• Patients with moderate-to-severe aortic stenosis had a higher median shear wave velocity than healthy volunteers (4.7 vs 3.4 m/sec; P = .035).
• In patients with native aortic valves, shear wave velocity showed a moderate correlation with BMI (correlation coefficient [r], 0.37; P = .024) and interventricular septal thickness (r, 0.38; P = .019).

IN PRACTICE

"Although image quality, measurement variability and lack of standardisation currently limit widespread application, SWV [shear wave velocity] has considerable promise as a biomarker for early detection, disease monitoring and therapy evaluation in pressure-overload cardiomyopathies," the researchers wrote.

SOURCE

The study was led by Robert R. Zwaan, Erasmus MC Universitair Medisch Centrum Rotterdam, Rotterdam, Netherlands. It was published online on June 19, 2026, in Open Heart.

LIMITATIONS

Measurements had variability, partly because of limited image quality and spatial resolution. Key steps required manual input, such as finding aortic valve closure and placing M-mode lines. Only regional measurements were obtained, which may not have reflected global left ventricular stiffness.

DISCLOSURES

The study received support from the Netherlands Cardiovascular Research Initiative, backed by the Dutch Heart Foundation and Hartekind. Additional support was provided in part by the Dutch Research Council. The authors did not declare any competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.