Relative Apical Sparing of Myocardial Longitudinal Strain Is Explained by Regional Differences in Total Amyloid Mass Rather Than the Proportion of Amyloid Deposits
| Autor: | William Sticka, Anthony P. Belanger, Marie Foley Kijewski, Paco E Bravo, Marcelo F. Di Carli, Rodney H. Falk, Raymond Y. Kwong, Sophia Jacob, Mohamed Samir El-Sady, Michael Jerosch-Herold, Kana Fujikura, Shipra Dubey, Mi-Ae Park, Sharmila Dorbala |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Amyloid medicine.medical_specialty Magnetic Resonance Imaging Cine 030204 cardiovascular system & hematology Ventricular Function Left 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Internal medicine Extracellular Humans Medicine Radiology Nuclear Medicine and imaging Prospective Studies Prospective cohort study Aged Aniline Compounds medicine.diagnostic_test business.industry Myocardium Amyloidosis Stroke Volume Middle Aged medicine.disease Pathophysiology Apex (geometry) Cardiac amyloidosis Echocardiography Positron emission tomography Positron-Emission Tomography Cardiology Ethylene Glycols Female Radiopharmaceuticals Cardiomyopathies Cardiology and Cardiovascular Medicine business |
| Zdroj: | JACC: Cardiovascular Imaging. 12:1165-1173 |
| ISSN: | 1936-878X |
| DOI: | 10.1016/j.jcmg.2018.06.016 |
| Popis: | This study sought to test whether relative apical sparing (RELAPS) of left ventricular (LV) longitudinal strain (LS) in cardiac amyloidosis (CA) is explained by regional differences in markers of amyloid burden (Further knowledge of the pathophysiological basis for RELAPS can help understand the adverse outcomes associated with apical LS impairment.This was a prospective study of 32 subjects (age 62 ± 7 years; 50% males) with light chain CA. All subjects underwent two-dimensional echocardiography for LS estimation andThere was a significant base-to-apex gradient in LS (-7.4 ± 3.2% vs. -8.6 ± 4.0% vs. -20.8 ± 6.6%; p 0.0001), maximal LV wall thickness (15.7 ± 1.9 cm vs. 15.4 ± 2.9 cm vs. 10.1 ± 2.4 cm; p 0.0001), and LV mass (74.8 ± 21.2 g vs. 60.8 ± 17.3 g vs. 23.4 ± 6.2 g; p 0.0001). In contrast, florbetapir RI (0.089 ± 0.03 μmol/min/g vs. 0.097 ± 0.03 μmol/min/g vs. 0.085 ± 0.03 μmol/min/g; p = 0.45) and ECV (0.53 ± 0.08 vs. 0.49 ± 0.08 vs. 0.49 ± 0.07; p = 0.15) showed no significant base-to-apex gradient in the tissue concentration or proportion of amyloid infiltration, whereas markers of total amyloid load, such as total florbetapir binding (3.4 ± 1.7 μmol/min vs. 2.8 ± 1.5 μmol/min vs. 0.93 ± 0.49 μmol/min; p 0.0001) and extracellular LV mass (40.0 ± 15.6 g vs. 30.2 ± 10.9 g vs. 11.6 ± 3.9 g; p 0.0001), did show a marked base-to-apex gradient.Segmental differences in the distribution of the total amyloid mass, rather than the proportion of amyloid deposits, appear to explain the marked regional differences in LS in CA. Although these 2 matrices are clearly related concepts, they should not be used interchangeably. |
| Databáze: | OpenAIRE |
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