Two-dimensional Strain Echocardiography Differentiates Cardiac Amyloidosis from Hypertrophic Cardiomyopathy with Preserved Ejection Fraction

Influence of Ventricular Wringing on the Preservation of Left Ventricular Ejection Fraction in Cardiac Amyloidosis

“…15 The dissociation between the preservation of LVEF and a reduction in GLS has been described as an accurate and reproducible parameter that can be used to differentiate CA from other causes of thickening of the left ventricle. [16][17][18] The LVEF results from the combined action of longitudinal and circumferential myocardial contraction. The distinctive helical structure of obliquely oriented myocardial fibers 19,20 results in systolic rotation of the base and apex of the left ventricle in opposite directions around its longitudinal axis and the simultaneous shortening of the left ventricle as the base is displaced toward the apex, [19][20][21][22][23][24] all of which results in ventricular wringing.…”