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

Abstract 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.