Visual Assessment of Relative Apical Sparing Pattern Is More Useful Than Quantitative Assessment for Diagnosing Cardiac Amyloidosis in Borderline or Mildly Increased Left Ventricular Wall Thickness

Lee, Ga Yeon; Kim, Yong Jin; Choi, Jin Oh; Chang, Sung‐A; Oh, Jae K.; Jeon, Eun Seok

doi:10.1253/circj.cj-14-1328

Cited by 21 publications

(20 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite being statistically significantly different, RAS LS assessed in the A4C alone cannot be used to discriminate ALAC from other causes of concentric LV wall thickening because of significant overlap. This observation is similar to findings of other authors . Nevertheless, our results show that addition of RAS LS in the A4C on the top of more traditional echocardiographic (E/e′, DT, pericardial effusion) and ECG (low QRS voltage and pseudoinfarct patterns) provides significant added diagnostic value in predicting ALAC.…”

Section: Discussionsupporting

confidence: 91%

Simplified apical four‐chamber view evaluation of relative apical sparing of longitudinal strain in diagnosing AL amyloid cardiomyopathy

et al. 2018

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 91%

Simplified apical four‐chamber view evaluation of relative apical sparing of longitudinal strain in diagnosing AL amyloid cardiomyopathy

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Reduced LVEF has been considered an independent predictor of cardiac mortality in AL amyloidosis 2 . However, subclinical dysfunction of the left ventricle can be observed by speckle tracking echocardiography in CA patients with preserved LVEF 5, 6 . Thus, LVEF is limited by its inability to assess regional function and less sensitive for the evaluation of early contractile impairment 7, 8 .…”

Section: Introductionmentioning

confidence: 99%

Myocardial Deformation in Cardiac Amyloid Light-chain Amyloidosis: Assessed with 3T Cardiovascular Magnetic Resonance Feature Tracking

Yang

et al. 2017

Sci Rep

View full text Add to dashboard Cite

Clinically, assessment of myocardial function is essential in patients with amyloid light-chain cardiac amyloidosis (AL-CA) to predict outcome and determine therapeutic approach. The aim of this study was to investigate the feasibility of cardiovascular magnetic resonance (CMR)-derived feature tracking algorithm for assessing left ventricular (LV) myocardial deformation in AL-CA, and to determine if these abnormal myocardial deformation parameters are correlated to impaired LV myocardial microvascular dysfunction. A total of 42 AL-CA patients, including 26 with preserved systolic function and 16 with impaired LVEF, and 35 healthy controls were enrolled and underwent CMR examination. Our result indicated that AL-CA patients had significantly reduced global peak strain (PS) (longitudinal, circumferential, and radial) (all P < 0.05). AL-CA patients with normal LVEF showed preserved longitudinal PS at apical and significantly reduced longitudinal PS at mid and basal segments. By Spearman's rank correlation analysis, the LV regional radial, circumferential, and longitudinal myocardial deformation values were correlated to myocardial upslope and MaxSI in CA, regardless of LVEF. This study indicated that the abnormal LV myocardial deformation of AL-CA patients can be monitored using feature tracking CMR, even in those with preserved LVEF; and the myocardial deformation was associated with coronary microvascular dysfunction.Cardiac amyloidosis (CA), characterized by extracellular deposition of pathologically insoluble proteins in heart tissue, is seen in more than one-half of the patients with systemic light-chain (AL) amyloidosis, and the major cause of death in these patients 1, 2 . Assessment of myocardial function is essential in patients with amyloidosis, as the extent and severity of cardiac involvement is the most significant indicator to determine patient prognosis 2-4 .Clinically, the left ventricular ejection fraction (LVEF), reflecting global LV systolic function, has remained the reference standard for the evaluation of ventricular function. Reduced LVEF has been considered an independent predictor of cardiac mortality in AL amyloidosis 2 . However, subclinical dysfunction of the left ventricle can be observed by speckle tracking echocardiography in CA patients with preserved LVEF 5,6 . Thus, LVEF is limited by its inability to assess regional function and less sensitive for the evaluation of early contractile impairment 7,8 .Cardiovascular magnetic resonance (CMR) tagging-derived myocardial strain values, which could measure cardiac muscle motion and deformation, have emerged as more sensitive indicators than EF for measurement of systolic function 9 . However, this established method is limited by time consuming and requiring additional sequence acquisition. As cine CMR imaging has relative high signal to noise, contrast to noise ratios and ability of unrestricted access to large fields of view, it could provide more accurate and reproducible assessment of changing

show abstract

“…Recently, it was reported that the finding is also clinically useful for detecting CA in less advanced patients with a borderline or mildly thickened LV wall (those with LV wall thickness values of <14 mm) (11). Our patient exhibited an LV wall thickness of 14 mm, which was suggestive of a less advanced stage of CA.…”

Section: Discussionmentioning

confidence: 99%

The Imaging Diagnosis of Less Advanced Cases of Cardiac Amyloidosis: The Relative Apical Sparing Pattern

et al. 2017

View full text Add to dashboard Cite

An early diagnosis is important for improving the prognosis of cardiac amyloidosis (CA). We herein describe the utility of two-dimensional speckle tracking echocardiography (2-D STE) in diagnosing CA at a less advanced stage. A 63-year-old woman with exertional dyspnea was suspected of having CA based on her echocardiographic and electrocardiographic findings. A myocardial biopsy was negative for amyloid deposits, while the relative apical sparing pattern was detected on 2-D STE, which was highly suggestive of CA. Chemotherapy was initiated as a treatment for CA, and the patient's symptoms were immediately relieved. Thereafter, amyloid deposits were detected in a skin biopsy specimen.

show abstract

Visual Assessment of Relative Apical Sparing Pattern Is More Useful Than Quantitative Assessment for Diagnosing Cardiac Amyloidosis in Borderline or Mildly Increased Left Ventricular Wall Thickness

Cited by 21 publications

References 23 publications

Simplified apical four‐chamber view evaluation of relative apical sparing of longitudinal strain in diagnosing AL amyloid cardiomyopathy

Simplified apical four‐chamber view evaluation of relative apical sparing of longitudinal strain in diagnosing AL amyloid cardiomyopathy

Myocardial Deformation in Cardiac Amyloid Light-chain Amyloidosis: Assessed with 3T Cardiovascular Magnetic Resonance Feature Tracking

The Imaging Diagnosis of Less Advanced Cases of Cardiac Amyloidosis: The Relative Apical Sparing Pattern

Contact Info

Product

Resources

About