Ultrasonic Texture Analysis Identifies Cardiac Microstructural Alterations in Immune-Inflammatory Disease

ABSTRACT Background Echocardiographic texture analysis using the signal intensity coefficient (SIC) can identify fibrosis-associated microstructural changes. This approach has not been tested in immune-inflammatory disease states such as myocarditis or transplant rejection. Methods Retrospective pilot analysis using the SIC was performed in populations including myocarditis (n=5), acute left anterior descending coronary artery STEMI (n=6), severe aortic stenosis with normal ejection fraction (n=7), ATTR amyloidosis (n=6), and cardiac transplant patients undergoing biopsy including patients with active rejection on histopathology (n=22), patients with history of rejection but no current rejection (n=15), and patients without history of or current rejection (n=5), and a healthy control group (n=28). Results Decreased SIC was noted in the myocarditis and transplant rejection populations, with decreasing SIC by presence and history of rejection. Consistent with prior literature, the SIC was elevated in cardiac conditions associated with fibrosis. Conclusions The SIC may be able to capture microstructural changes associated with immune-inflammatory processes such as cardiac transplant rejection and myocarditis.