Increased cardiac stiffness, a marker of morbimortality, is found in several heart diseases included heart failure with preserved ejection fraction. Unfortunately, the heart is inaccessible to palpation and elastometry, a surrogate for stiffness assessment, could be an alternative. This CPP approved study investigates whether elastometry can be measured in the heart.

In 20 anesthetized patients for cardiac surgery, elastometry was measured epicardially and longitudinally both on the right and left ventricle using a standoff. Image acquisition was made after the last cardiac beat in a loaded heart using a dedicated probe connected to a platform for elastometry measurement. Measurements were made off-line. Ejection fraction was 63±5%, left ventricular end-diastolic diameter was 54±2mm and E/A ratio was 1.18±0.01. Mean right ventricular elastometry was lower than left ventricular elastometry (14.9±3.8 kPa vs. 22.1±5.3 kPa, p = 0.0001). Whichever the ventricle, epicardial elastometry was higher than endocardial elastometry resulting in an outer/inner myocardial elastometry gradient (see figure).

The heart is remotely palpable by echography resulting in higher left ventricular elastometry than in the right ventricle and an epi- to endocardial gradient.