CMR-based right ventricular strain analysis in cardiac amyloidosis and its potential as a supportive diagnostic feature
- \(\it Background:\) Right ventricular (RV) strain has provided valuable prognostic information for patients with \(\underline {cardiac amyloidosis}\) (CA). However, the extent to which RV strain and strain rate can differentiate CA is not yet clinically established. CA underdiagnosis delays treatment strategies and exacerbates patient prognosis. \(\it Aims:\) Evaluation of \(\underline {cardiac magnetic resonance}\) (CMR) quantified RV global and regional strain of CA and \(\underline {HCM}\) patients along with CA subtypes. \(\it Methods:\) CMR feature tracking attained longitudinal, radial and circumferential global and regional strain in 47 control subjects (CTRL), 43 CA-, 20 hypertrophic cardiomyopathy- (HCM) patients. CA patients were subdivided in 21 transthyretin-related amyloidosis (ATTR) and 20 acquired immunoglobulin light chain (AL) patients. Strain data and baseline clinical parameters were statistically analysed with respect to \(\underline {diagnostic performance}\) and discriminatory power between the different clinical entities. \(\it Results:\) Effective differentiation of CA from HCM patients was achieved utilizing global longitudinal (GLS: 16.5 \(\pm\) 3.9% vs. −21.3 \(\pm\) 6.7%, p = 0.032), radial (GRS: 11.7 \(\pm\) 5.3% vs. 16.5 \(\pm\) 7.1%, p < 0.001) and circumferential (GCS: -7.6 \(\pm\) 4.0% vs. −9.4 \(\pm\) 4.4%, p = 0.015) right ventricular strain. Highest strain-based hypertrophic phenotype differentiation was attained using GRS (AUC = 0.86). Binomial regression found right \(\underline {ventricular ejection fraction}\) (RV-EF) (p = 0.017) to be a significant predictor of CA-HCM differentiation. CA subtypes had comparable cardiac strains. \(\it Conclusion:\) CMR-derived RV global strains and various regional longitudinal strains provide discriminative radiological features for CA-HCM differentiation. However, in terms of feasibility, cine-derived RV-EF quantification may suffice for efficient differential diagnostic support.
Author: | Jan Wigand EcksteinORCiDGND, Hermann KörperichORCiDGND, Elena Weise ValdésGND, Vanessa SciaccaORCiDGND, Lech PaluszkiewiczORCiDGND, Wolfgang BurchertORCiDGND, Martin FarrORCiDGND, Philipp SommerORCiDGND, Christian SohnsORCiDGND, Misagh PiranORCiDGND |
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URN: | urn:nbn:de:hbz:294-104603 |
DOI: | https://doi.org/10.1016/j.ijcha.2022.101167 |
Parent Title (English): | IJC heart & vasculature |
Publisher: | Elsevier |
Place of publication: | Amsterdam |
Document Type: | Article |
Language: | English |
Date of Publication (online): | 2023/11/21 |
Date of first Publication: | 2022/12/28 |
Publishing Institution: | Ruhr-Universität Bochum, Universitätsbibliothek |
Tag: | Open Access Fonds Amyloidosis subtypes; Cardiac amyloidosis; Cardiovascular magnetic resonance imaging; Global and regional strain; Hypertrophic phenotype |
Volume: | 44 |
Issue: | Article 101167 |
First Page: | 101167-1 |
Last Page: | 101167-9 |
Note: | Article Processing Charge funded by the Deutsche Forschungsgemeinschaft (DFG) and the Open Access Publication Fund of Ruhr-Universität Bochum. |
Institutes/Facilities: | Herz- und Diabeteszentrum NRW, Institut für Radiologie, Nuklearmedizin und molekulare Bildgebung |
Dewey Decimal Classification: | Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit |
open_access (DINI-Set): | open_access |
Licence (English): | Creative Commons - CC BY-NC-ND 4.0 - Attribution-NonCommercial-NoDerivatives 4.0 International |