Naslov
Predictive value of systolic and diastolic strain rate for survival in cardiac amyloidosis patients with preserved ejection fraction

Autori
Liu, D ; Hu, K ; Stoerk, S ; Herrmann, S ; Kramer, B ; Cikes, M ; Gaudron, PD ; Ertl, G ; Bijnens, B ; Weidemann, F

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

Izvornik
European Heart Journal / - , 2014

Skup
ESC Congress 2014

Mjesto i datum
Barcelona, Španjolska, 30.08.2014. - 03.09.2014

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
systolic and diastolic strain rate; cardiac amyloidosis; preserved ejection fraction

Sažetak
Purpose: Recent studies showed that reduced longitudinal systolic strain assessedby speckle tracking imaging (STI) is related to increased mortality in patients with cardiac amyloidosis (CA). Since diastolic abnormalities are typical findings of CA, we hypothesized that longitudinal early diastolic strain rate (LSRdias)could be used as an early predictor for mortality in CA patients with preserved left ventricular ejection fraction (EF>50%). Methods: Conventional echocardiography and 2D-speckle tracking imaging were performed in 41 CA patients with preserved EF (25 male ; mean age 65°æ9 years). Global and segmental longitudinal systolic strain (LSsys) and diastolic strain rate (LSRdias) were obtained in six segments of the left ventricle from apical 4-chamber views. CA patients were followed up for a median of 16 months (quartiles 5-35 months). The primary endpoint was all-cause mortality. Results: Nineteen (46%) out of 41 CA patients died during follow-up. In respect to clinical and conventional systolic and diastolic echocardiographic data, lateral mitral annular plane systolic excursion (MAPSE) was significantly lower in nonsurvivors compared to survivors (7°æ2mm vs. 9°æ3 mm, P=0.029). Among systolic strain parameters, mid-septal LSsys tended to be lower in non-survivors than in survivors (-9°æ4% vs. -12°æ5%, P=0.052). Diastolic strain rate analysis showed that global LSRdias and basal-septal LSRdias were significantly lower in nonsurvivors than in survivors (all P<0.05). Basal-septal LSRdias cut-off value of 0.40 1/S was the best diastolic strain rate parameter for predicting death in this cohort (sensitivity=74% and specificity=71%). Univariate Cox analysis revealed that NYHA class III/IV (HR=3.21, P=0.017), reduced mid-septal LSsys (<11% ; HR=4.05, P=0.009), reduced global LSRdias (<0.85 1/S ; HR=3.97, P=0.007) and basal-septal LSRdias (<0.40 1/S ; HR=4.46, P=0.005) were predictors for mortality in CA patients with preserved EF. Reduced basal-septal LSRdias (HR=4.00, 95% CI: 1.03-15.54, P=0.045) remained independently related to increased mortality in these patients after adjusting for age, gender, NYHA class, number of organ involvements and left ventricular mass index. Conclusions: Speckle-tracking-imaging derived diastolic strain rate is a powerful predictor for survival of CA patients with preserved EF.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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