Related Experiment Video
Updated: Jul 7, 2026
Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging
Published on: February 7, 2014
Natural Shear Wave Velocities at Rest Are Associated with Impaired Cardiopulmonary Fitness in Childhood Cancer
Ahmed S Youssef1, Sabine Verschueren2, Deveny Vanrusselt3
1Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; Department of Cardiovascular Medicine, Suez Canal University, Ismailia, Egypt.
Background:
Childhood cancer survivors (CCSs) may face hidden cardiotoxicity undetectable by conventional echocardiography; yet it may be related to the impaired cardiopulmonary fitness (CPF) commonly observed in CCSs. High frame rate (HFR) echocardiography captures natural myocardial shear waves (SWs) after mitral valve closure (MVC), providing insights into myocardial stiffness (MS), one of the main determinants of diastolic function. This study explores cardiac function including SW velocities in CCSs compared to healthy peers and its relation to CPF (VO2peak).
Methods:
We enrolled 142 participants, including 77 asymptomatic CCSs (median age, 19 years [interquartile range, 16,22]) and 65 age- and sex-matched healthy volunteers (HVs). All participants underwent resting conventional and HFR echocardiography, followed by an incremental, symptom-limited cardiopulmonary exercise test on a treadmill to determine VO2peak. Based on exercise performance, CCSs and HVs were subsequently classified as fit or nonfit.
Results:
In our CCS cohort (mean time since treatment, 5.0 ± 2.9 years), 9.1% had mildly reduced ejection fraction and 14.3% impaired global longitudinal strain. However, neither correlated with VO2peak (P > .05), although GLS showed modest correlation with VO2peak standardized to age, sex, and weight (percentage predicted VO2peak). Among diastolic indices, E-wave deceleration time was shorter in nonfit CCSs versus fit CCSs and HVs (P < .001) and correlated with the percentage predicted VO2peak in the CCS cohort (r = 0.6, P < .001). Interestingly, SW velocities after MVC were significantly higher in nonfit CCSs than in fit CCSs, fit HVs, and nonfit HVs (4.1 ± 0.5 vs 3.3 ± 0.3 vs 3.2 ± 0.3 vs 3.4 ± 0.2 m/s, respectively; P < .001). Additionally, SW velocities strongly correlated with VO2peak (percentage predicted; r = -0.74, P < .001) and predicted impaired CPF with 90% accuracy in CCS.
Conclusions:
Our findings suggest that resting SW velocities may sensitively indicate increased MS and subclinical cardiac dysfunction, helping to explain impaired CPF in CCSs. Natural SW imaging could have added value in assessing cardiac function and CPF within cardio-oncology, although further studies are needed to confirm its role.
