Value of assessing left ventricular longitudinal systolic peak strain in differential diagnosis of primary cardiac amyloidosis from hypertrophic cardiomyopathy
10.3969/j.issn.1673-4254.2014.05.03
- VernacularTitle:左室长轴收缩期峰值应变在原发性心脏淀粉样变性与肥厚型心肌病诊断中的价值
- Author:
Lu ZHANG
1
;
Ye WANG
;
Liuquan CHENG
;
Jing WANG
;
Xiao ZHOU
;
Miao LIU
;
Wei ZHANG
;
Ming ZHANG
;
Bo ZHANG
;
Guang ZHI
Author Information
1. 解放军总医院心内科
- Keywords:
primary cardiac amyloidosis;
hypertrophic cardiomyopathy;
echocardiography;
velocity vector imaging;
myocardial strain;
cardiac magnetic resonance
- From:
Journal of Southern Medical University
2014;(5):609-616
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the endocardial, myocardial, and epicardial longitudinal systolic strain (LSsys) in the left ventricle (LV) segments and walls in patients with cardiac involvement due to primary amyloidosis (AL-CA) and hypertrophic cardiomyopathy (HCM). Methods Twenty patients with biopsy-proven AL-CA, 20 with asymmetric HCM, and 20 age-matched healthy volunteers were analyzed for their clinical characteristics and underwent conventional echocardiography for evaluating LV wall thickness, left atrial and ventricle size, systolic and diastolic function and 2-dimensional velocity vector imaging for evaluating the endocardial, myocardial and epicardial LSsys of the LV segments and walls. AL-CA and HCM patients also underwent cardiac magnetic resonance to evaluate the late gadolinium enhancement (LGE) features. Results Compared with the control group, AL-CA and HCM groups, with similar clinical symptoms and physical signs, both showed increased LV wall thickness, left atrial diameter, E/A ratio, septal E/e' ratio and the prevalence of granular sparkling. LV segments and walls endocardial LSsys were significantly lower in AL-CA patients than in HCM patients and the control subjects. The endocardial-epicardial LSsys difference in all the left ventricle walls were significantly smaller in AL-CA group than in the control group, but this difference appeared variable in HCM group. The LGE also presented with different features in AL-CA and HCM:AL-CA group showed subendocardial LGE in almost all the LV walls, but HCM group showed patchy LGE with a regional, multifocal distribution. Conclusion AL-CA is characterized by a significantly reduced endocardial LSsys in the LV segments and an uniform decrease of the endocardial-epicardial LSsys difference in all the LV walls, but the changes in HCM appear variable, and 2-dimensional velocity vector imaging is therefore a useful modality to differentiate AL-CA from HCM.
