Naslov
Longitudinal base-to-apex strain gradient is a good diagnostic marker for differentiating patients with cardiac amyloidosis from other hypertrophic cardiomyopathies.

Autori
Hu, Kai ; Liu, Dan ; Niemann, Markus ; Herrmann, Sebastian ; Čikeš, Maja ; Störk, Stefan ; Knop, S. ; Ertl, Georg ; Bijnens, Bart ; Weidemann, Frank.

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
European Heart Journal / - , 2012, 15-15

Skup
ESC Congress 2012

Mjesto i datum
München, Njemačka, 25.08.2012. - 29.08.2012

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Amyloidosis; hypertrophic cardiomyopathies; speckle tracking imaging; early diastolic filling

Sažetak
Background: Differentiation of cardiac amyloidosis (CA) from other non-CA hypertrophic cardiomyopathies remains a major challenge in clinical practice. Methods and Results: Consecutive concentric hypertrophic patients (all with mean left ventricular wall thickness > 11 mm) with CA (n=25), Friedreich's ataxia (FA, n=25), Fabry disease (n=25), isolated arterial hypertension (AH, n=25) and 25 non hypertrophic healthy controls were recruited. Standard echocardiography was performed and segmental longitudinal peak systolic strain (LSsys) in the septum was assessed by speckle tracking imaging in all subjects. Mean LV thickness (13.7±1.6mm) and ejection fraction was similar among 4 patient groups. Deceleration time of early filling (DT) was significantly lower in CA group than in controls, Fabry and AH groups. Septal basal LSsys (-6±2%) was significantly lower in the CA group than in controls (-17±3%), FA (-16±2%), Fabry (-13±6%) and AH (-13±6%) groups (P<0.001) while septal apical LSsys was similar among all groups (P>0.05). The ratio apical LSsys/basal LSsys in the septum (LSapi/bas) >2.1 was used as cut-off value for differentiating CA from other hypertrophic cardiomyopathies with a sensitivity and specificity of 88% and 85%, respectively (The area of the receiver operating characteristic was 0.91 (95% CI: 0.84-0.97)). The prevalence of LSapi/bas>2.1 in patients with CA (=88%) was significantly higher than in controls (0%), FA (0%), Fabry (12%), AH (32%) groups. The prevalence of LSapi/bas>2.1 + DT<200ms was 88% in CA group and in none of control, FA, Fabry and AH groups (sensitivity 88%, specificity 100%). Conclusions: The longitudinal base-to-apex strain gradient within the septum (LSapi/bas>2.1) in combination with short deceleration time of early diastolic filling could be a useful echocardiographic marker for differentiating CA from other hypertrophic cardiomyopathies.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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