Role of Right Ventricular Strain Measured by Two-Dimensional Echocardiography in the Diagnosis of Cardiac Amyloidosis

Palomero, V. Moñivas; Durante-López, Alejandro; Sanabria, Mario Torres; Cubero, Javier Segovia; González-Mirelis, Jesús; López-Ibor, Jorge Vázquez; Rico, Sara M. Navarro; Krsnik, Isabel; Domínguez, Fernándo; Mingo, Alejandro; Hernández-Pérez, Francisco; Cavero, Gibanel; Mingo, Susana

doi:10.1016/j.echo.2019.03.005

Cited by 33 publications

(24 citation statements)

References 28 publications

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“…In CA patients, RV involvement happens in more advanced stages of the disease. Similar to our results, in another study, impaired RV-free wall longitudinal strain in patients with CA was reported [ 30 ]. We postulated that CP patients might have preserved RVGLS compared with CA cases and that it could be utilized as a CMR marker.…”

Section: Discussionsupporting

confidence: 93%

“…The preservation of LV apical longitudinal strain in CA may be related to low amyloid deposition in this region compared with the base, and it is a sensitive and specific marker in CA patients [ 29 ]. Interestingly, Moñivas Palomero et al described an apical sparing pattern in the RV as previously described in the LV [ 30 ]. Singh et al mentioned that the accuracy of apical sparing in strain values for the diagnosis of amyloid light chain was reduced in patients with chronic kidney disease [ 31 ].…”

Section: Discussionmentioning

confidence: 67%

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The Auxiliary Role of Cardiac Magnetic Resonance Feature-Tracking Parameters in the Differentiation between Cardiac Amyloidosis and Constrictive Pericarditis

Asadian

Farzin

Tabesh

et al. 2021

Cardiology Research and Practice

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Objectives. Cardiac amyloidosis (CA) and constrictive pericarditis (CP) are described as the differential diagnoses of restrictive hemodynamic alterations of the heart. We aimed to explain cardiac magnetic resonance (CMR) imaging findings (especially feature tracking (FT)) of CA and CP cases and compare them with healthy controls. Moreover, we evaluated the role of biventricular FT parameters in differentiating CA from CP. Methods. Thirty-eight patients who underwent CMR between February 2016 and January 2018 with the ultimate diagnosis of CA (19 patients) or CP (19 patients) were enrolled. We included biopsy-proven light-chain amyloidosis patients. The data of 28 healthy controls were utilized for comparison. The patients were followed up for 8–23 months to register mortality and their surveillance. All CMR morphological and functional data, including FT parameters, were recorded and analyzed. Results. Of only 13/19 (68.4%) CA patients who had the follow-up data, 11/13 (84.6%) died. One of The CP patients (5.3%) expired during the follow-up. Significant between-group differences were noted concerning the biventricular ejection fraction as well as global longitudinal, circumferential, and radial strain values ( P s < 0.001 ). The left ventricular (LV) global longitudinal strain (GLS) ≤10% was detected in 13/19 (68.4%) of the CA and 1/19 (5.3%) of CP cases ( P < 0.001 ). A significant difference between the mean value of the LVGLS and LV global circumferential strain (GCS) of the basal LV level compared to the mid and apical levels was observed ( P s < 0.001 ) in the CA patients. The differences between the mean LVGLS and the GCS measures of the mid and apical LV levels were not significant ( P = 1 and P = 0.06 , respectively). Conclusions. In our study, CA and CP severely disrupted ventricular strains. Biventricular GLS was meaningfully lower in the CA subjects. Therefore, strain analysis, especially in the longitudinal direction, could be helpful to differentiate CA from CP.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 67%

The Auxiliary Role of Cardiac Magnetic Resonance Feature-Tracking Parameters in the Differentiation between Cardiac Amyloidosis and Constrictive Pericarditis

Asadian

Farzin

Tabesh

et al. 2021

Cardiology Research and Practice

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“…Right ventricular strain can also be measured on echocardiogram; however, this technique is not used in widespread clinical practice. Palomero and colleagues ( 40 ) evaluated RV strain in a group of AL and ATTR-CA patients (n = 78) compared to controls. All patients had reduced biventricular function and LV apical sparing.…”

Section: Echocardiographymentioning

confidence: 99%

Multimodality Imaging in the Evaluation and Prognostication of Cardiac Amyloidosis

Scheel

Mukherjee

Hays

et al. 2022

Front. Cardiovasc. Med.

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Cardiac amyloidosis (CA) is an infiltrative cardiomyopathy resulting from deposition of misfolded immunoglobulin light chains (AL-CA) or transthyretin (ATTR-CA) proteins in the myocardium. Survival varies between the different subtypes of amyloidosis and degree of cardiac involvement, but accurate diagnosis is essential to ensure initiation of therapeutic interventions that may slow or potentially prevent morbidity and mortality in these patients. As there are now effective treatment options for CA, identifying underlying disease pathogenesis is crucial and can be guided by multimodality imaging techniques such as echocardiography, magnetic resonance imaging, and nuclear scanning modalities. However, as use of cardiac imaging is becoming more widespread, understanding optimal applications and potential shortcomings is increasingly important. Additionally, certain imaging modalities can provide prognostic information and may affect treatment planning. In patients whom imaging remains non-diagnostic, tissue biopsy, specifically endomyocardial biopsy, continues to play an essential role and can facilitate accurate and timely diagnosis such that appropriate treatment can be started. In this review, we examine the multimodality imaging approach to the diagnosis of CA with particular emphasis on the prognostic utility and limitations of each imaging modality. We also discuss how imaging can guide the decision to pursue tissue biopsy for timely diagnosis of CA.

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“…This imaging method offers the advantage of early detection of pathologies that cannot be detected by operator experience or visual assessment. Early diagnosis of subclinical myocardial dysfunction in many systemic storage diseases has been provided through strain echocardiography 20–23 …”

Section: Introductionmentioning

confidence: 99%

“…Early diagnosis of subclinical myocardial dysfunction in many systemic storage diseases has been provided through strain echocardiography. [20][21][22][23] In the study, we aimed to evaluate subclinical LV functions by strain echocardiography in patients with PEX syndrome, in which many materials have been shown to accumulate in the extracellular matrix.…”

mentioning

confidence: 99%

Pseudoexfoliation syndrome: Are the eyes the mirror of the heart?

2021

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Pseudoexfoliation (PEX) syndrome is a disease characterized by the production of fibrillar material in the extracellular matrix and its progressive accumulation in various intraocular and extraocular tissues. 1 It was first described in 1917 by being associated with open-angle glaucoma. 2 Its prevalence increases with age and while it is around 3% in the whole population, it can be detected in more than 10% of advanced age. 3 The incidence of the disease in the population varies regionally and coastal European countries have

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Role of Right Ventricular Strain Measured by Two-Dimensional Echocardiography in the Diagnosis of Cardiac Amyloidosis

Cited by 33 publications

References 28 publications

The Auxiliary Role of Cardiac Magnetic Resonance Feature-Tracking Parameters in the Differentiation between Cardiac Amyloidosis and Constrictive Pericarditis

The Auxiliary Role of Cardiac Magnetic Resonance Feature-Tracking Parameters in the Differentiation between Cardiac Amyloidosis and Constrictive Pericarditis

Multimodality Imaging in the Evaluation and Prognostication of Cardiac Amyloidosis

Pseudoexfoliation syndrome: Are the eyes the mirror of the heart?

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