Abstract 11213: Global Left Ventricular Longitudinal, Circumferential Strain, and Torsion Assessed by Speckle Tracking Echocardiography in Patients With Transthyretin Associated (ATTR) Cardiac Amyloidosis
Background: Transthyretin associated amyloidosis (ATTR) with heart failure is associated with decreased longitudinal left ventricular (LV) myocardial contraction measured by strain and strain rate Doppler echocardiography. We sought to clarify whether speckle tracking echocardiography give more information in ATTR cardiac amyloidosis.
Methods: We examined 123 consecutive patients with ATTR amyloidosis. Patients were divided into 3 groups. Group 1 patients had no evidence of cardiac involvement (n=47), group 2 had heart involvement but no congestive heart failure (CHF) and /or serum BNP levels<100pg/ml (n=35), and group 3 had heart involvement and CHF (n=41). All patients underwent standard 2 dimensional (2D), Doppler echo, and speckle tracking echocardiography.
Results: With the use of standard 2D and Doppler echo, differences in parameters were only apparent between group 3 and groups 1 and 2. Global circumferential strains at each LV level and LV torsion differentiated between group 1 and groups 2 and 3 but could not differentiate between group 2 and 3. In contrast, global longitudinal LV strain calculated by automatic functional imaging showed significant differences among all 3 groups (-17.3 ± 2.3, -13.3 ± 2.3, -9.9 ± 3.3 for groups 1 to 3, respectively, P<0.0001).
Conclusions: Cardiac amyloidosis (ATTR) is characterized by progressive impairment in longitudinal LV function at a time when global circumferential shortening remains unchanged.
- © 2011 by American Heart Association, Inc.