Usefulness of automatic assessment for longitudinal strain to diagnose wild-type transthyretin amyloid cardiomyopathy
Background: Left ventricular (LV) apical sparing by transthoracic echocardiography (TTE) has not been widely accepted to diagnose transthyretin amyloid cardiomyopathy (ATTR-CM), because it is time consuming and requires a level of expertise. We hypothesized that automatic assessment may be the solut...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906723000581 |
| _version_ | 1797752961562050560 |
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| author | Hiroki Usuku Eiichiro Yamamoto Daisuke Sueta Kanako Imamura Fumi Oike Kyohei Marume Masanobu Ishii Shinsuke Hanatani Yuichiro Arima Seiji Takashio Seitaro Oda Hiroaki Kawano Mitsuharu Ueda Hirotaka Matsui Kenichi Tsujita |
| author_facet | Hiroki Usuku Eiichiro Yamamoto Daisuke Sueta Kanako Imamura Fumi Oike Kyohei Marume Masanobu Ishii Shinsuke Hanatani Yuichiro Arima Seiji Takashio Seitaro Oda Hiroaki Kawano Mitsuharu Ueda Hirotaka Matsui Kenichi Tsujita |
| author_sort | Hiroki Usuku |
| collection | DOAJ |
| description | Background: Left ventricular (LV) apical sparing by transthoracic echocardiography (TTE) has not been widely accepted to diagnose transthyretin amyloid cardiomyopathy (ATTR-CM), because it is time consuming and requires a level of expertise. We hypothesized that automatic assessment may be the solution for these problems. Methods-and-Results: We enrolled 63 patients aged ≥70 years who underwent 99mTc-labeled pyrophosphate (99mTc-PYP) scintigraphy on suspicion of ATTR-CM and performed TTE by EPIQ7G, and had enough information for two-dimensional speckle tracking echocardiography at Kumamoto University Hospital from January 2016 to December 2019. LV apical sparing was described as a high relative apical longitudinal strain (LS) index (RapLSI). Measurement of LS was repeated using the same apical images with three different measurement packages as follows: (1) full-automatic assessment, (2) semi-automatic assessment, and (3) manual assessment. The calculation time for full-automatic assessment (14.7 ± 1.4 sec/patient) and semi-automatic assessment (66.7 ± 14.4 sec/patient) were significantly shorter than that for manual assessment (171.2 ± 59.7 sec/patient) (p < 0.01 for both). Receiver operating characteristic curve analysis showed that the area under curve of the RapLSI evaluated by full-automatic assessment for predicting ATTR-CM was 0.70 (best cut-off point; 1.14 [sensitivity 63%, specificity 81%]), by semi-automatic assessment was 0.85 (best cut-off point; 1.00 [sensitivity, 66%; specificity, 100%]) and by manual assessment was 0.83 (best cut-off point; 0.97 [sensitivity, 72%; specificity, 97%]). Conclusion: There was no significant difference between the diagnostic accuracy of RapLSI estimated by semi-automatic assessment and that estimated by manual assessment. Semi-automatically assessed RapLSI is useful to diagnose ATTR-CM in terms of rapidity and diagnostic accuracy. |
| first_indexed | 2024-03-12T17:11:00Z |
| format | Article |
| id | doaj.art-1e13b99a91f24ec2a1c24aab5d6fe3c6 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-03-12T17:11:00Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-1e13b99a91f24ec2a1c24aab5d6fe3c62023-08-06T04:37:49ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672023-08-0147101227Usefulness of automatic assessment for longitudinal strain to diagnose wild-type transthyretin amyloid cardiomyopathyHiroki Usuku0Eiichiro Yamamoto1Daisuke Sueta2Kanako Imamura3Fumi Oike4Kyohei Marume5Masanobu Ishii6Shinsuke Hanatani7Yuichiro Arima8Seiji Takashio9Seitaro Oda10Hiroaki Kawano11Mitsuharu Ueda12Hirotaka Matsui13Kenichi Tsujita14Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, Japan; Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, Japan; Corresponding author at: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, JapanDepartment of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, JapanDepartment of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, JapanCenter of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, Japan; Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, KumamotoDepartment of Molecular Laboratory Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Center of Metabolic Regulation of Healthy Aging, Kumamoto University, Faculty of Life Sciences, Kumamoto, JapanBackground: Left ventricular (LV) apical sparing by transthoracic echocardiography (TTE) has not been widely accepted to diagnose transthyretin amyloid cardiomyopathy (ATTR-CM), because it is time consuming and requires a level of expertise. We hypothesized that automatic assessment may be the solution for these problems. Methods-and-Results: We enrolled 63 patients aged ≥70 years who underwent 99mTc-labeled pyrophosphate (99mTc-PYP) scintigraphy on suspicion of ATTR-CM and performed TTE by EPIQ7G, and had enough information for two-dimensional speckle tracking echocardiography at Kumamoto University Hospital from January 2016 to December 2019. LV apical sparing was described as a high relative apical longitudinal strain (LS) index (RapLSI). Measurement of LS was repeated using the same apical images with three different measurement packages as follows: (1) full-automatic assessment, (2) semi-automatic assessment, and (3) manual assessment. The calculation time for full-automatic assessment (14.7 ± 1.4 sec/patient) and semi-automatic assessment (66.7 ± 14.4 sec/patient) were significantly shorter than that for manual assessment (171.2 ± 59.7 sec/patient) (p < 0.01 for both). Receiver operating characteristic curve analysis showed that the area under curve of the RapLSI evaluated by full-automatic assessment for predicting ATTR-CM was 0.70 (best cut-off point; 1.14 [sensitivity 63%, specificity 81%]), by semi-automatic assessment was 0.85 (best cut-off point; 1.00 [sensitivity, 66%; specificity, 100%]) and by manual assessment was 0.83 (best cut-off point; 0.97 [sensitivity, 72%; specificity, 97%]). Conclusion: There was no significant difference between the diagnostic accuracy of RapLSI estimated by semi-automatic assessment and that estimated by manual assessment. Semi-automatically assessed RapLSI is useful to diagnose ATTR-CM in terms of rapidity and diagnostic accuracy.http://www.sciencedirect.com/science/article/pii/S2352906723000581Transthyretin amyloid cardiomyopathyTwo-dimensional speckle tracking echocardiographyRelative apical longitudinal strain indexAutomatic assessment |
| spellingShingle | Hiroki Usuku Eiichiro Yamamoto Daisuke Sueta Kanako Imamura Fumi Oike Kyohei Marume Masanobu Ishii Shinsuke Hanatani Yuichiro Arima Seiji Takashio Seitaro Oda Hiroaki Kawano Mitsuharu Ueda Hirotaka Matsui Kenichi Tsujita Usefulness of automatic assessment for longitudinal strain to diagnose wild-type transthyretin amyloid cardiomyopathy International Journal of Cardiology: Heart & Vasculature Transthyretin amyloid cardiomyopathy Two-dimensional speckle tracking echocardiography Relative apical longitudinal strain index Automatic assessment |
| title | Usefulness of automatic assessment for longitudinal strain to diagnose wild-type transthyretin amyloid cardiomyopathy |
| title_full | Usefulness of automatic assessment for longitudinal strain to diagnose wild-type transthyretin amyloid cardiomyopathy |
| title_fullStr | Usefulness of automatic assessment for longitudinal strain to diagnose wild-type transthyretin amyloid cardiomyopathy |
| title_full_unstemmed | Usefulness of automatic assessment for longitudinal strain to diagnose wild-type transthyretin amyloid cardiomyopathy |
| title_short | Usefulness of automatic assessment for longitudinal strain to diagnose wild-type transthyretin amyloid cardiomyopathy |
| title_sort | usefulness of automatic assessment for longitudinal strain to diagnose wild type transthyretin amyloid cardiomyopathy |
| topic | Transthyretin amyloid cardiomyopathy Two-dimensional speckle tracking echocardiography Relative apical longitudinal strain index Automatic assessment |
| url | http://www.sciencedirect.com/science/article/pii/S2352906723000581 |
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