Abstract
To assess the diagnostic utility of a simplified approach to relative apical sparing of longitudinal strain (RAS LS) using only an apical four-chamber view (A4C) in patients with AL amyloid cardiomyopathy (ALAC). We retrospectively evaluated echocardiographic recordings of 20 patients with ALAC, 20 patients with Fabry disease-related cardiomyopathy (FD), and 20 patients with concentric hypertensive left ventricular hypertrophy (HLVH) matched for mean LV mean thickness. Peak segmental LS values of the interventricular septum and lateral LV wall were measured in the A4C using two-dimensional speckle-tracking echocardiography. RAS LS was calculated as average apical LS/(average basal LS + average midventricular LS). Relative apical sparing of longitudinal strain values in patients with ALAC (1.23 ± 0.64) were significantly higher than those in FD patients (0.75 ± 0.19, P < 0.05) as well as in individuals with HLVH (0.75 ± 0.23, P < 0.05), but with a significant overlap. The optimal RAS LS value differentiating ALAC from FD and HLVH with 70% sensitivity and 75% specificity was 0.88 (AUC 0.79). In multivariate modeling, RAS LS was significantly additive to traditional predictors of ALAC (low QRS voltage and pseudoinfarct ECG pattern...Continue Reading
References
Feb 15, 1986·The American Journal of Cardiology·R B DevereuxN Reichek
Jan 5, 2005·Circulation·Alicia Maria MaceiraDudley John Pennell
Feb 8, 2005·The American Journal of Cardiology·Blaithnead MurtaghMartha Grogan
Jul 27, 2005·American Journal of Hematology·Morie A GertzGiles Grateau
Sep 19, 2006·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Christine M EngWilliam R Wilcox
Jun 30, 2010·Echocardiography·Robert N BelkinUmadevi S Katta
Dec 15, 2010·Heart·S W DubreyR H Falk
Feb 23, 2011·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Victor Mor-AviJosé Luis Zamorano
Aug 7, 2012·Heart·Dermot PhelanJames D Thomas
Oct 9, 2013·Circulation. Cardiovascular Imaging·Dan LiuFrank Weidemann
Jan 7, 2015·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Roberto M LangJens-Uwe Voigt
Apr 10, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Ga Yeon LeeDae-Won Sohn
Oct 29, 2015·European Heart Journal·Otto A SmisethStig Urheim
Feb 3, 2016·Heart·Alpana SenapatiDermot Phelan
Apr 3, 2016·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Sherif F NaguehAlan D Waggoner
Apr 28, 2017·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Axel Van Der GuchtEmmanuel Itti
May 1, 2017·Heart·Martha GroganMorie A Gertz
Aug 9, 2017·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Lynne K WilliamsPaaladinesh Thavendiranathan