Longitudinal strain of left ventricular basal segments and E/e′ ratio differentiate primary cardiac amyloidosis at presentation from hypertensive hypertrophy: an automated function imaging study

• Published in: Echocardiography (Mount Kisco, N.Y.) N.Y.), 2016-09, Vol.33 (9), p.1335-1343
• Main Authors: Schiano-Lomoriello, Vincenzo, Galderisi, Maurizio, Mele, Donato, Esposito, Roberta, Cerciello, Giuseppe, Buonauro, Agostino, Della Pepa, Roberta, Picardi, Marco, Catalano, Lucio, Trimarco, Bruno, Pane, Fabrizio
• Format: Article
• Language: English
• Subjects: Amyloidosis - complications; Amyloidosis - diagnostic imaging; Amyloidosis - physiopathology; cardiac amyloidosis; Diagnosis, Differential; diastolic function; Doppler tissue imaging; Echocardiography - methods; Elastic Modulus; Elasticity Imaging Techniques - methods; Female; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Hypertension - complications; Hypertension - diagnostic imaging; Hypertension - physiopathology; Hypertrophy, Left Ventricular - diagnostic imaging; Hypertrophy, Left Ventricular - etiology; Hypertrophy, Left Ventricular - physiopathology; Image Interpretation, Computer-Assisted - methods; left ventricular filling pressures; Male; Middle Aged; myocardial strain; Reproducibility of Results; Sensitivity and Specificity; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - etiology; Ventricular Dysfunction, Left - physiopathology
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/echo.13278

Background Longitudinal strain is an early marker of left ventricular (LV) dysfunction in several cardiac diseases. Our aim was to differentiate cardiac amyloidosis (CA) at diagnosis from hypertensive LV hypertrophy (LVH) by analysis of longitudinal myocardial deformation. Methods Thirty healthy controls (C), 30 newly diagnosed, never treated hypertensives with LVH (H‐LVH), and 33 patients with CA at diagnosis underwent echo Doppler including speckle tracking–based automated function imaging (AFI). Averaged peak systolic global longitudinal strain (GLS, 18 segments) and basal, middle, and apical longitudinal strain (BLS, MLS, and ALS, respectively, six segments each) were calculated. Results Left ventricular mass index, relative wall thickness, and ejection fraction did not differ between H‐LVH and CA. E/e′ ratio was higher in CA than in H‐LVH (P