Naslov
Impact of regional left ventricular function on diagnosis, staging and prognosis in patients with cardiac amyloidosis.

Autori
Liu, Dan ; Hu, Kai ; Niemann, Markus ; 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, 736-736

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; LV function; strain; speckle tracking imaging;

Sažetak
Objectives: To describe the relationship between deformation and clinical staging and prognosis in cardiac amyloidosis (CA) patients. Background: Detecting subclinical cardiac involvement in CA patients by advanced non- invasive techniques might be favorable for improving outcome. Methods: Longitudinal, circumferential and radial peak systolic strain (Ssys) were assessed by speckle tracking imaging (STI) in 44 biopsy-proven CA patients and 30 normal controls. Patients were divided into compensated (n=18) and decompensated CA (n=26) group based on clinical assessment and followed-up for a median period of 345 days. Results: Ejection fraction (EF) was preserved while longitudinal Ssys (LSsys) was significantly reduced in both CA groups. An intra-wall gradient with lower basal LSsys and higher apical LSsys was documented in CA patients. NYHA class, LV wall- thickness and diastolic dysfunction increased, while EF, septal mitral annular displacement and tricuspid plane annular systolic excursion decreased in proportion with increasing number of segments with reduced LSsys. Patchy distributed late enhancement detected by cardiac magnetic- resonance imaging in the LV was evidenced in 71% CA patients. Incidence of death or heart transplantation was significantly higher in decompensated (65%) group than in compensated CA group (22%, P=0.001) during follow-up. Mortality risk increased with increasing number of segments with reduced LSsys (risk ratio: 2.4, 95% CI: 1.4- 3.9). Conclusions: Global LV function is preserved but regional longitudinal function is severely compromised in CA patients featuring a characteristic base-to-apex gradient within one wall. Increasing number of segments with abnormal deformation is associated with adverse remodeling and poorer prognosis in CA patients.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA