Myocardial Work Appraisal in Transthyretin Cardiac Amyloidosis and Nonobstructive Hypertrophic Cardiomyopathy

Global left ventricular (LV) myocardial work (MW) indices can be recognized at ultrasound imaging from the pressure/global longitudinal strain (GLS) loop analysis. Four indices, global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE) have be...

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Bibliographic Details
Published in:The American journal of cardiology 2023-12, Vol.208, p.173-179
Main Authors: de Gregorio, Cesare, Trimarchi, Giancarlo, Faro, Denise Cristiana, De Gaetano, Fabrizio, Campisi, Mariapaola, Losi, Valentina, Zito, Concetta, Tamburino, Corrado, Bella, Gianluca Di, Monte, Ines Paola
Format: Article
Language:English
Subjects:
Amyloidosis
Automation
Blood pressure
Cardiac Amyloidosis
Cardiology
Cardiomyopathy
Comparative studies
Ejection fraction
Electrocardiography
Enrollments
Heart
Hypertension
Hypertrophic Cardiomyopathy
Myocardial Function
Myocardial Work
Pathophysiology
Patients
Physiology
Strain analysis
Strain Echocardiography
Subgroups
Transthyretin
Transthyretin Amyloidosis
Ultrasonic imaging
Variables
Ventricle
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Summary:Global left ventricular (LV) myocardial work (MW) indices can be recognized at ultrasound imaging from the pressure/global longitudinal strain (GLS) loop analysis. Four indices, global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE) have been demonstrated to overcome the methodological limitations of GLS and provide useful information on myocardial dysfunction in several clinical settings. Impaired MW indices have been demonstrated in patients with transthyretin cardiac amyloidosis (ATTR) or nonobstructive hypertrophic cardiomyopathy (HCM), but there are no comparative studies. The present study aimed at describing the characteristics of MW in both these clinical settings, compared with well-controlled hypertensive patients (HTN). Eighty-three patients, 32 with ATTR (aged 70 ± 11 years, 32% mutated, 68% wild-type, 72% males), 29 with HCM (aged 57 ± 17 years) and 22 HTN controls (aged 56 ± 5.6 years, 59 % males) were prospectively enrolled at two Clinical Centers. Everyone was class NYHA 1 or 2. Overall, LV mass index was greater in both study groups, whereas LV ejection fraction (EF) was significantly lower in ATTR compared with the normal values in HCM and HTN patients. Based on LVEF, ATTR patients were further divided into 2 subgroups: ATTR1 (LVEF≤ 0.50), n=14 (44%); and ATTR2 (LVEF>0.50), n=18 (56%). Overall, GWI and GCW were lower in ATTR patients (ATTR1>ATTR2) than in the other groups (p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2023.09.055