High‐Precision Transthoracic Ultrasound Therapy for Heart Failure with Nondiffractive Airy Beams Generated by Metasurfaces

Heart failure (HF), a life-threatening condition marked by high morbidity and mortality, lacks effective non-pharmacological and minimally invasive treatments. This study presents a novel therapeutic strategy using Airy-beam ultrasound (Airy-US), a non-invasive approach that enables precise cardiac targeting. By employing a 3D-printed ultrasound metasurface, Airy-US generates non-diffractive beams capable of bypassing the ribcage and achieving subwavelength focusing (full width at half maximum, FWHM, 0.8 λ) in deep cardiac tissue. Compared to conventional planar ultrasound (Plane-US), which suffers from waveform distortion and off-target effects, Airy-US preserves focus and reduces unintended impact on surrounding tissue, evidenced by decreased R-R interval variance (3.85 to 2.56 ms). In a doxorubicin (DOX)-induced murine HF model, Airy-US significantly improved cardiac function and reduced myocardial fibrosis without invasive procedures. Moreover, it demonstrated superior biosafety by minimizing arrhythmias. These results highlight the potential of Airy-US as a precise and safe therapeutic modality for HF and possibly other fibrotic diseases. Its ability to focus energy through bone structures opens new opportunities for non-invasive subcostal organ treatments.