Left atrial dysfunction in light-chain cardiac amyloidosis and hypertrophic cardiomyopathy – A comparative three-dimensional speckle-tracking echocardiographic analysis from the MAGYAR-Path Study

Földeák, Dóra; Kormányos, Árpád; Domsik, Péter; Kalapos, Anita; Piros, Györgyike Ágnes; Ambrus, Nóra; Ajtay, Zénó; Sepp, Róbert; Borbényi, Zita; Forster, Tamás; Nemes, Attila

doi:10.1016/j.repc.2017.06.014

Cited by 15 publications

(5 citation statements)

References 23 publications

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“…In a recent study, severe LA dysfunction could be demonstrated in AL-CA, therefore the role of LA-RA interactions could also not be excluded. 28 Segmental RA strain analyses showed RA regional differences, suggesting their different contributions to RA (dys)function, as mentioned before (non-uniformity of RA dysfunction). Further studies are needed to confirm our findings in a larger population, comparing results to other diseases with LV hypertrophy as well.…”

Section: Discussionsupporting

confidence: 63%

Right Atrial Deformation Analysis in Cardiac Amyloidosis - Results from the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Path Study

Nemes¹,

Földeák²,

Domsik³

et al. 2018

Arquivos Brasileiros De Cardiologia

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BackgroundLight-chain (AL) cardiac amyloidosis (CA) is characterized by fibril deposits, which are composed of monoclonal immunoglobulin light chains. The right ventricle is mostly involved in AL-CA and impairment of its function is a predictor of worse prognosis.ObjectivesTo characterize the volumetric and functional properties of the right atrium (RA) in AL-CA by three-dimensional speckle-tracking echocardiography (3DSTE).MethodsA total of 16 patients (mean age: 64.5 ± 10.1 years, 11 males) with AL-CA were examined. Their results were compared to that of 15 age- and gender-matched healthy controls (mean age: 58.9 ± 6.9 years, 8 males). All cases have undergone complete two-dimensional Doppler and 3DSTE. A two-tailed p value of less than 0.05 was considered statistically significant.ResultsSignificant differences could be demonstrated in RA volumes respecting cardiac cycle. Total (19.2 ± 9.3% vs. 27.9 ± 10.7%, p = 0.02) and active atrial emptying fractions (12.1 ± 8.1 vs. 18.6 ± 9.8%, p = 0.05) were significantly decreased in AL-CA patients. Peak global (16.7 ± 10.3% vs. 31.2 ± 19.4%, p = 0.01) and mean segmental (24.3 ± 11.1% vs. 38.6 ± 17.6%, p =0.01) RA area strains, together with some circumferential, longitudinal and segmental area strain parameters, proved to be reduced in patients with AL-CA. Global longitudinal (4.0 ± 5.2% vs. 8.2 ± 5.5%, p = 0.02) and area (7.8 ± 8.1% vs. 15.9 ± 10.3%, p = 0.03) strains at atrial contraction and some circumferential and area strain parameters at atrial contraction were reduced in AL-CA patients.ConclusionSignificantly increased RA volumes and deteriorated RA functions could be demonstrated in AL-CA.

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Section: Discussionsupporting

confidence: 63%

Right Atrial Deformation Analysis in Cardiac Amyloidosis - Results from the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Path Study

Nemes¹,

Földeák²,

Domsik³

et al. 2018

Arquivos Brasileiros De Cardiologia

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“…By contrast, echocardiography remains the first-line imaging technique for patients presenting with heart failure, but diagnosis of CA is frequently delayed or missed, due in part to the limited sensitivity and specificity of the wall thickness alone, or wall thickness plus NT-proBNP, as recommended by the current diagnostic criteria. (4,5) Echocardiographic findings that have been proposed for diagnosis of CA range from conventional LV remodelling parameters to those evaluating diastolic function and deformation (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Multiparametric Echocardiography Scores for the Diagnosis of Cardiac Amyloidosis

Boldrini

Cappelli

Chacko

et al. 2020

JACC: Cardiovascular Imaging

177

163

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Background: Cardiac amyloidosis (CA) is a serious though increasingly treatable cause of heart failure. Diagnosis is challenging and frequently unclear at echocardiography, which remains the most often used imaging tool. Objectives:We aimed to study the accuracy of a broad range of echocardiographic variables to develop multiparametric scores to diagnose CA in patients with proven light chain (AL) amyloidosis or those with increased heart wall thickness (IWT) in whom amyloid was suspected. We also aimed to further characterise structural and functional changes associated with amyloid infiltration. Methods:We studied 1187 consecutive patients evaluated at 3 referral centres for CA and analysed morphological, functional and strain-derived echo parameters with the aim of developing a score-based diagnostic algorithm. Cardiac amyloid burden was quantified using extracellular volume measurements at cardiac magnetic resonance.Results: 332 patients were diagnosed with AL amyloidosis and 339 patients with transthyretin (ATTR) CA. Concentric remodelling and strain-derived parameters displayed the best diagnostic performance. A multivariable logistic regression model incorporating relative wall thickness, E/e'ratio, longitudinal strain and tricuspid annular plane systolic excursion had greatest diagnostic performance in AL amyloidosis (area under the curve -AUC-0.90[95% confidence interval 0.87-0.92]), whilst addition of septal apical-to -base ratio yielded the best diagnostic accuracy in the IWT group (AUC 0.87[0.85-0.9]).Conclusions: Specific functional and structural parameters characterize different burdens of CA deposition with different diagnostic performances, and enable to define two scores that are sensitive and specific tools to diagnose or exclude CA.

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“…Increased interventricular septum thickness, decreased LV-EF and Doppler velocity E/e’ ratio suggesting abnormal systolic and diastolic LV function could be seen in CA [1] . In recent 3DSTE studies, detailed analysis confirmed significant abnormalities in LV rotational mechanics with 60% ratio of near absence of LV twist (LV ‘rigid body rotation’) [17] with reduced LV strains [18] and enlarged LA volumes and functional deteriorations [19] . Associated with these alterations, MA proved to be dilated and functionally impaired [20] .…”

Section: Discussionmentioning

confidence: 97%

The tricuspid annulus in amyloidosis with cardiac involvement: Detailed analysis from the three-dimensional speckle tracking echocardiographic MAGYAR-Path Study

Nemes¹,

Rácz²,

Kormányos³

et al. 2022

IJC Heart & Vasculature

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Left atrial dysfunction in light-chain cardiac amyloidosis and hypertrophic cardiomyopathy – A comparative three-dimensional speckle-tracking echocardiographic analysis from the MAGYAR-Path Study

Abstract: Different patterns of LA functional characteristics were demonstrated in AL-CA and HCM patients by 3D-STE.

Cited by 15 publications

References 23 publications

Right Atrial Deformation Analysis in Cardiac Amyloidosis - Results from the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Path Study

Right Atrial Deformation Analysis in Cardiac Amyloidosis - Results from the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Path Study

Multiparametric Echocardiography Scores for the Diagnosis of Cardiac Amyloidosis

The tricuspid annulus in amyloidosis with cardiac involvement: Detailed analysis from the three-dimensional speckle tracking echocardiographic MAGYAR-Path Study

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