Preservation of Circumferential and Radial Left Ventricular Function as a Mitigating Mechanism for Impaired Longitudinal Strain in Early Cardiac Amyloidosis.
Cardiac amyloidosis
Cardiac magnetic resonance
Cardiomyopathy
Echocardiography
Journal
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
ISSN: 1097-6795
Titre abrégé: J Am Soc Echocardiogr
Pays: United States
ID NLM: 8801388
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
05
05
2023
revised:
05
07
2023
accepted:
01
08
2023
medline:
5
12
2023
pubmed:
14
8
2023
entrez:
13
8
2023
Statut:
ppublish
Résumé
In patients with cardiac amyloidosis (CA), left ventricular ejection fraction (LVEF) is frequently preserved, despite commonly reduced global longitudinal strain (GLS). We hypothesized that nonlongitudinal contraction may initially serve as a mitigating mechanism to maintain cardiac output and studied the relationship between global circumferential (GCS) and radial (GRS) strain with LVEF and extracellular volume (ECV), a marker of amyloid burden. Patients with CA who underwent cardiac magnetic resonance (CMR; n = 140, 70.7 ± 11.5 years, 66% male) or echocardiography (n = 67, 71 ± 13 years, 66% male) and normal controls (CMR, n = 20; echocardiography, n = 45) were retrospectively identified, and GCS, GLS, and GRS were quantified using feature-tracking CMR or speckle-tracking echocardiography and compared between CA patients with preserved and reduced LVEF (CA While echocardiography-derived GLS was impaired in both CA Among CA patients with preserved LVEF, preserved GCS and GRS, despite near-universally impaired GLS, may be explained by an initial predominantly subendocardial involvement, where mostly longitudinal fibers are located. If confirmed in future studies, these findings may facilitate identification of patients with early stages of CA, when treatments may be most effective.
Sections du résumé
BACKGROUND
BACKGROUND
In patients with cardiac amyloidosis (CA), left ventricular ejection fraction (LVEF) is frequently preserved, despite commonly reduced global longitudinal strain (GLS). We hypothesized that nonlongitudinal contraction may initially serve as a mitigating mechanism to maintain cardiac output and studied the relationship between global circumferential (GCS) and radial (GRS) strain with LVEF and extracellular volume (ECV), a marker of amyloid burden.
METHODS
METHODS
Patients with CA who underwent cardiac magnetic resonance (CMR; n = 140, 70.7 ± 11.5 years, 66% male) or echocardiography (n = 67, 71 ± 13 years, 66% male) and normal controls (CMR, n = 20; echocardiography, n = 45) were retrospectively identified, and GCS, GLS, and GRS were quantified using feature-tracking CMR or speckle-tracking echocardiography and compared between CA patients with preserved and reduced LVEF (CA
RESULTS
RESULTS
While echocardiography-derived GLS was impaired in both CA
CONCLUSIONS
CONCLUSIONS
Among CA patients with preserved LVEF, preserved GCS and GRS, despite near-universally impaired GLS, may be explained by an initial predominantly subendocardial involvement, where mostly longitudinal fibers are located. If confirmed in future studies, these findings may facilitate identification of patients with early stages of CA, when treatments may be most effective.
Identifiants
pubmed: 37574149
pii: S0894-7317(23)00418-2
doi: 10.1016/j.echo.2023.08.005
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1290-1301Informations de copyright
Copyright © 2023 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.