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Alterations in regional myocardial deformation assessed by strain imaging in cardiac amyloidosis

Citation

Lo, Q and Haluska, B and Chia, E-M and Lin, M-W and Richards, D and Marwick, T and Thomas, L, Alterations in regional myocardial deformation assessed by strain imaging in cardiac amyloidosis, Echocardiography, 33, (12) pp. 1844-1853. ISSN 1540-8175 (2016) [Refereed Article]

Copyright Statement

2016, Wiley Periodicals, Inc.

DOI: doi:10.1111/echo.13355

Abstract

BACKGROUND: Cardiac amyloidosis results in increased left ventricular (LV) wall thickness and diastolic dysfunction (DD). Strain measurements using velocity vector imaging (VVI) may further characterize myocardial dysfunction.

METHODS: A total of 43 AL amyloidosis patients were compared to age-matched normals and hypertensive patients (HT). Subgroup analysis within the amyloid group was performed based on LV wall thickness (≤14 mm, >14 mm) and diastolic dysfunction (DD) (Group 1: normal and impaired relaxation, Group 2: pseudonormal, Group 3: restrictive). LV strain (longitudinal, circumferential, and radial strain (S) and strain rate [Sr]) were measured using velocity vector imaging (VVI).

RESULTS: Increased LV wall thickness and DD were observed in the amyloid group. Global longitudinal (-13.94.1% vs -16.73.8%; P=.002) and radial (27.413.4% vs 38.815.7%; P<.001) strain were lower in the amyloid group vs normal controls, while circumferential strain was similar. Segmental analysis demonstrated reduced mid- and basal segmental strain with relative sparing of apical segments in the amyloid group. Reduced longitudinal and radial strain, with preserved circumferential strain, were observed in patients with wall thickness >14 mm; however, circumferential strain was also altered when severe DD (restrictive filling) was present.

CONCLUSION: Reduction in longitudinal and radial S and Sr was evident using VVI strain analysis in amyloidosis, with segmental heterogeneity in longitudinal S. There was relative preservation of circumferential strain, which was reduced only in patients with severe DD.

Item Details

Item Type:Refereed Article
Keywords:amyloidosis, hypertension, left ventricle, strain, strain rate, velocity vector imaging
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Marwick, T (Professor Tom Marwick)
ID Code:116926
Year Published:2016
Deposited By:Menzies Institute for Medical Research
Deposited On:2017-05-25
Last Modified:2017-11-03
Downloads:0

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