Clinical Application Value Of Real-time Shear Wave Elastography In Evaluating Skeletal Muscle Changes In Patients With Chronic Heart Failure

Objective To explore the clinical application value of SWE in evaluating gastrocnemius muscle changes in patients with chronic left heart failure by using real-time shear wave elastography(SWE)to evaluate the stiffness of skeletal muscle.Methods A total of 50 patients with chronic heart failure and 30 healthy volunteers were included in this study.Real-time SWE technology was used to measure the Young’s modulus value and shear wave propagation velocity(SWV)of the lateral head of the gastrocnemius muscle in two groups of subjects under two different states(resting state and stretching state),respectively.Statistical analysis was performed on the obtained data,and box plots were made.According to the left ventricular ejection fraction(LVEF)and NYHA cardiac function classification,the heart failure group were divided into different subgroups,and the Young ’s modulus value and SWV of the gastrocnemius muscle of the examinee in the different subgroups were compared using one-way ANOVA.Finally,correlation analysis was performed.Finally,correlation analysis was performed on the LVEF,NYHA cardiac function grade,B-type natriuretic peptide(BNP)and age of the heart failure group with the patients’ Young’s modulus values and SWV in the stretched state,respectively.The difference was statistically significant with P<0.05.Results1.When the gastrocnemius muscle is at rest state,there was no significant difference between young’s modulus and SWV between the two groups(P>0.05).When the gastrocnemius muscle was in the stretching state,the Young’s modulus value of the heart failure group and SWV was significantly lower than the control group,and the difference was statistically significant(P<0.05).2.When the gastrocnemius muscle is in the stretched state,for the heart failure group,in the three subgroups divided by LVEF,the Young’s modulus value and SWV of the HFpEF group were higher than those of the other two groups(all P<0.05),andthe Young’s modulus and SWV of the HFmrEF group were higher than those of the HFrEF group(P<0.05),the differences were statistically significant.In the three subgroups with NYHA cardiac function classification as the standard score,the Young’s modulus value and SWV of NYHA class I were higher than those of NYHA class II and III,the difference was statistically significant(all P<0.05).The Young’s modulus value and SWV of NYHA class II were higher than those of NYHA class III,the difference was statistically significant(P<0.05).3.For the heart failure group,when the gastrocnemius muscle is in the stretched state,its LVEF is significantly positively correlated with its Young’s modulus value and SWV(r = 0.779,P <0.001;r = 0.789,P < 0.001);its BNP is negatively correlated with its Young’s modulus value and SWV(r =-0.577,P < 0.001;r =-0.577,P <0.001);NYHA is negatively correlated with its Young’s modulus value and SWV(r =-0.487,P < 0.001;r =-0.479,P < 0.001),age is negatively correlated with its Young’s modulus value and SWV(r =-0.363,P < 0.001;r =-0.366,P < 0.001).Conclusion The gastrocnemius muscle stiffness in patients with chronic heart failure decreases during stretching,and it is positively correlated with LVEF and negatively correlated with NYHA cardiac function grade and BNP.Therefore,real-time shear wave elastography can be used to assess the stiffness of skeletal muscle in patients with CHF,thereby assessing changes in muscle contractility,helping clinicians to formulate early rehabilitation programs for patients,and improving muscle contraction function.