Abstract 12412: Peak Systolic Velocity of Pulmonary Venous Flow is Closely Associated with Left Ventricular Global Longitudinal Strain, Which is a Powerful Predictor of Clinical Outcome, in Patients with Light-Chain Amyloidosis
Background: Recent studies demonstrated that left ventricular (LV) longitudinal strain is a powerful predictor of clinical outcome and is superior to standard 2-dimensional echocardiographic and Doppler flow measurements in patients with light-chain (AL) amyloidosis. In these studies, pulmonary venous flow parameters were strong predictors of cardiac death. We hypothesized that peak systolic velocity of pulmonary venous flow (PVF) and peak diastolic/systolic (D/S) velocity ratio of PVF are associated with global LV longitudinal strain (GLS) in patients with AL amyloidosis.
Methods: We prospectively examined 187 consecutive biopsy proven patients with AL amyloidosis. The GLS was calculated from the basal, mid, and apical LV multiple walls in apical 2- and 4-chamber views and the 12 values were averaged. The prognostic value of these parameters was compared with standard 2-dimensional echocardiographic and Doppler measurements of transmitral and PVF. Linear regression analysis was also performed between PVF parameters and GLS.
Results: Forty patients died during a mean follow up period of 302 days. Univariate analysis showed that the mean basal strain was the best predictor of cardiac death (Chi-square value = 20.66, p<0.0001). The peak D/S velocity ratio of PVF was also a strong predictor of cardiac death (Chi-square value = 19.14, P<0.0001). Linear regression analysis demonstrated that the peak systolic velocity (S) and the peak D/S velocity ratio of PVF were strongly associated with GLS (R=0.67, P<0.0001; R=0.66, P<0.0001, respectively).
Conclusions: The simple measurements of PVF −S and PVF −D/S are powerful predictors of clinical outcome and these parameters are strongly associated with GLS, an “established prognostic factor” in patients with AL amyloidosis.
- © 2010 by American Heart Association, Inc.