Focused Ultrasound Therapy
Focused ultrasound is a rapidly evolving, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with congestive heart failure (CHF). This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue.
How it Works
Focused ultrasound produces precise thermal ablation of the infarcted region to shrink the size of the infarcted region. The goal is to achieve the right amount of tissue reduction to offset the post-myocardial tissue expansion that is typically seen. A recent publication showed a decrease in tissue strain in the affected region. Additional research will likely be needed prior to clinical trials.
Advantages
The primary options for treatment of CHF include medication but may also include invasive surgery.
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications – such as surgical wound healing or infection – at a lower cost. Focused ultrasound can also reach the desired target without damaging surrounding tissue, and it can be repeated, if necessary.
Clinical Trials
At the present time, there are no clinical trials recruiting patients for focused ultrasound CHF treatments.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for CHF is not yet approved by regulatory bodies or covered by medical insurance companies.
Notable Papers
Zhong S, Cai Q, Zhong L, Wang Y, Liang F, Deng Z, Li S, Zha D, Qiu W, Wu J. Low-Intensity Focused Ultrasound Ameliorates Ischemic Heart Failure Related to the Cholinergic Anti-Inflammatory Pathway. J Ultrasound Med. 2023 Feb;42(2):463-475. doi: 10.1002/jum.16140. Epub 2022 Nov 29.
Choi YA, Jung JY, Park JW, Lee MS, Kim TK, Lee SGW, Lee YH, Kim KH. Association between focused cardiac ultrasound and time to furosemide administration in acute heart failure. Am J Emerg Med. 2022 Jul 16;59:156-161. doi: 10.1016/j.ajem.2022.07.020.
Chou YY, Ward JL, Barron LZ, Murphy SD, Tropf MA, Lisciandro GR, Yuan L, Mochel JP, DeFrancesco TC. Focused ultrasound of the caudal vena cava in dogs with cavitary effusions or congestive heart failure: A prospective, observational study. PLoS One. 2021 May 28;16(5):e0252544. doi: 10.1371/journal.pone.0252544. eCollection 2021.
Chaudhury A, Wanek A, Ponnalagu D, Singh H, Kohut A. Use of Speckle Tracking Echocardiography to Detect Induced Regional Strain Changes in the Murine Myocardium by Acoustic Radiation Force. J Cardiovasc Imaging. 2021 Feb 10. doi: 10.4250/jcvi.2020.0148.
Greillier P, Ankou B, Bour P, Zorgani A, Abell E, Lacoste R, Bessière F, Pernot M, Catheline S, Quesson B, Chevalier P, Lafon C. Myocardial Thermal Ablation with a Transesophageal High-Intensity Focused Ultrasound Probe: Experiments on Beating Heart Models. Ultrasound Med Biol. 2018 Sep 9. pii: S0301-5629(18)30268-0. doi: 10.1016/j.ultrasmedbio.2018.06.013.
Miller DL, Lu X, Dou C, Zhu YI, Fuller R, Fields K, Fabiilli ML, Owens GE, Gordon D, Kripfgans OD. Ultrasonic Cavitation-Enabled Treatment for Therapy of Hypertrophic Cardiomyopathy: Proof of Principle. Ultrasound Med Biol. 2018 Jul;44(7):1439-1450. doi: 10.1016/j.ultrasmedbio.2018.03.010. Epub 2018 Apr 19. PMID:29681423
Douglas L. Miller, Xiaofang Lu, Chunyan Dou, Yiying I. Zhu, Mario L. Fabiilli, Gabe E. Owens, Oliver D. Kripfgans. Multiple ultrasound cavitation-enabled treatments for myocardial reduction. Journal of Therapeutic Ultrasound. 2017 5:29.
Laughner JI, Sulkin MS, Wu Z, Deng CX, Efimov IR. Three potential mechanisms for failure of high intensity focused ultrasound ablation in cardiac tissue. Circ Arrhythm Electrophysiol. 2012 Apr;5(2):409-16. doi: 10.1161/CIRCEP.111.967216.
Otsuka R, Fujikura K, Abe Y, Okajima K, Pulerwitz T, Engel DJ, Muratore R, Ketterling JA, Kalisz A, Sciacca R, Marboe C, Yi G, Wang J, Homma S. Extracardiac ablation of the left ventricular septum in beating canine hearts using high-intensity focused ultrasound. J Am Soc Echocardiogr. 2007 Dec;20(12):1400-6.
Yin X, Epstein LM, Hynynen K.Noninvasive transesophageal cardiac thermal ablation using a 2-D focused, ultrasound phased array: a simulation study. IEEE Trans Ultrason Ferroelectr Freq Control. 2006 Jun;53(6):1138-49.
Click here for additional references from PubMed.
