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Updated: Jul 15, 2026
Ultrasonic Assessment of Myocardial Microstructure
Published on: January 14, 2014
Myocardial ultrasound tissue characterization in patients with chronic renal failure
Massimo Salvetti1, Maria Lorenza Muiesan, Anna Paini
1Department of Medical and Surgical Sciences, University of Brescia, c/o Spedali Civili, 2a Medicina, Brescia 25100, Italy. salvetti@med.unibs.it
Insights
Ultrasound tissue characterization detected increased myocardial collagen in chronic kidney disease (CKD) patients. Acoustic densitometry shows potential for assessing these early cardiac changes in CKD.
Area of Science:
- Cardiology
- Nephrology
- Biomedical Engineering
Background:
- Chronic kidney disease (CKD) is associated with cardiovascular complications.
- Myocardial structural changes, particularly interstitial collagen deposition, are implicated in CKD-related heart disease.
- Non-invasive methods to assess these changes are needed.
Purpose of the Study:
- To detect ultrastructural myocardial changes related to collagen content using ultrasound tissue characterization.
- To evaluate these changes in patients with chronic kidney disease (CKD) and compare them to controls.
Main Methods:
- Utilized integrated backscatter signal (IBS) analysis via acoustic densitometry.
- Evaluated left ventricular anatomy and function using conventional echocardiography.
- Compared IBS mean reflectivity and cyclic variation in hemodialysis (HD) patients, chronic renal failure (CRF) patients, and essential hypertension (EH) controls.
Main Results:
- IBS mean reflectivity increased progressively from EH (48%) to CRF (56%) to HD patients (62%) (P < 0.01).
- IBS mean cyclic variation increased from HD patients (4.35 dB) to CRF (5.27 dB) to EH (6.50 dB) (P < 0.01).
- Multivariate analysis linked higher IBS reflectivity to age and serum creatinine, and higher cyclic variation to cardiac function parameters.
Conclusions:
- Interstitial collagen deposition may occur early in the course of CKD.
- Acoustic densitometry shows promise as a tool for assessing myocardial tissue alterations in CKD patients.
- These findings highlight the utility of ultrasound tissue characterization in understanding CKD cardiotoxicity.
Abstract:
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 (beta 0.351, P = 0.036; and beta = 0.408, P = 0.016, respectively). IBS mean cyclic variation was inversely related to age and serum creatinine (beta = -0.274, P = 0.025; and beta = -0.262, P = 0.025, respectively) and positively related to left ventricular midwall fractional shortening and transmitral E/A ratio (beta = 0.269, P < 0.05; and beta = 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.
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