Circulation, Vol 81, 58-64, Copyright © 1990 by American Heart Association
E Picano, G Pelosi, M Marzilli, F Lattanzi, A Benassi, L Landini and A L'Abbate
The aim of this study was to assess in vivo whether the regional ultrasonic
reflectivity, evaluated by a real-time integrated backscatter analysis, was
related to the local content of connective tissue in human myocardium as
estimated by quantitative histology of endomyocardial biopsies. Sixteen
patients with presumptive diagnosis of cardiomyopathy were ultrasonically
studied by means of an M-mode-based echocardiographic system with
quantitative integrated backscatter analysis capabilities. A 2.25-MHz
transducer was used. The integrated value of the rectified radiofrequency
signal of the interventricular septum was taken as integrated backscatter
index and expressed in percent normalized for the pericardial interface
(assumed to be 100%). All patients also underwent multiple left ventricular
endomyocardial biopsies, which were stained with Masson's trichrome and
studied with the use of a computer-assisted image analysis system. The
percent integrated backscatter index was significantly higher in the
presence of connective tissue area greater than 20% (eight patients) versus
less than 20% (eight patients): 51 +/- 25% versus 26 +/- 11%, p less than
0.05. A significant correlation (p less than 0.05, R = 0.55) was found
between percent integrated backscatter index and percent connective tissue
area. In vivo on-line quantitative ultrasound analysis is feasible in man
and reliably identifies variations in the regional extent of fibrosis in
human myocardium.
ARTICLES
In vivo quantitative ultrasonic evaluation of myocardial fibrosis in humans
CNR Clinical Physiology Institute, University of Pisa, Italy.
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