Clinical significance of the relative apical sparing pattern of longitudinal strain in patients with cardiac amyloidosis
| Autor: | Katsuji Inoue, Yasuhisa Nakao, Y Kawachi, R Higaki, Makoto Saito, A Ogimoto, M Suzuki, Osamu Yamaguchi, Y Yokomoto, Hideki Okayama, Hiroshi Kawakami, Shuntaro Ikeda, Go Hiasa |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
biology medicine.diagnostic_test Longitudinal strain business.industry Left ventricular hypertrophy medicine.disease Transthyretin Blood pressure Cardiac amyloidosis Internal medicine Biopsy Medical imaging medicine biology.protein Cardiology Clinical significance Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Heart Journal. 41 |
| ISSN: | 1522-9645 0195-668X |
| DOI: | 10.1093/ehjci/ehaa946.1012 |
| Popis: | Background The relative apical sparing pattern (RASP) of left ventricular (LV) longitudinal strain (LS) is frequently associated with cardiac amyloidosis (CA). However, some patients with CA do not show the RASP, and their clinical characteristics have not been fully clarified. We sought to investigate the clinical significance of RASP in patients with CA. Methods One hundred consecutive CA patients who were diagnosed by biopsy or myocardial pyrophosphate scintigraphy and evaluated for RASP (mean age: 76 years, male: 77%, LV mean wall thickness: 13.5 mm, light-chain [AL] type: 33 cases, transthyretin [TTR] type: 67 cases) were retrospectively enrolled. The RASP was semi-quantitatively and quantitatively assessed. Semi-quantitative RASP was defined as reduction of LS (≥−10%) in ≥5 (of 6) basal segments relative to preserved LS (1.00, >0.90, and >0.87) according to the literature. Results Semi-quantitative and binalized quantitative RASP (>1.00, >0.90, and >0.87) were observed in 55, 55, 63, and 65 patients, respectively. RASP in each definition was more prevalent in the TTR group than in the AL group. Additionally, RASP was significantly associated with higher LV wall thickness even after adjustment for the CA subtypes (all, p Conclusions The incidence of RASP is low in the case of thin LV wall thickness in CA patients, which may indicate the difficulty of early diagnosis of CA using RASP in patients with mild LV hypertrophy. The prognostic prediction using RASP may be challenging in this cohort. Figure 1 Funding Acknowledgement Type of funding source: None |
| Databáze: | OpenAIRE |
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