RWT/SaVR—A Simple and Highly Accurate Measure Screening for Transthyretin Cardiac Amyloidosis
Background: Cardiac amyloidosis is an underdiagnosed condition and simple methods for accurate diagnosis are warranted. We aimed to validate a novel, dual-modality approach to identify transthyretin cardiac amyloidosis (ATTR-CA), employing echocardiographic relative wall thickness (RWT), and ECG S-w...
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| Format: | Article |
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MDPI AG
2022-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/14/4120 |
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| author | Elsa Arnberg Per Eldhagen Viktor Löfbacka Ashwin Venkateshvaran Björn Pilebro Per Lindqvist |
| author_facet | Elsa Arnberg Per Eldhagen Viktor Löfbacka Ashwin Venkateshvaran Björn Pilebro Per Lindqvist |
| author_sort | Elsa Arnberg |
| collection | DOAJ |
| description | Background: Cardiac amyloidosis is an underdiagnosed condition and simple methods for accurate diagnosis are warranted. We aimed to validate a novel, dual-modality approach to identify transthyretin cardiac amyloidosis (ATTR-CA), employing echocardiographic relative wall thickness (RWT), and ECG S-wave from aVR (SaVR), and compare its accuracy with conventional echocardiographic approaches. Material and methods: We investigated 102 patients with ATTR-CA and 65 patients with left ventricular hypertrophy (LVH), all with septal thickness > 14 mm. We validated the accuracy of echocardiographic measures, including RWT, RWT/SaVR, posterior wall thickness (PWT), LV mass index (LVMI), left atrial volume index (LAVI), global longitudinal strain (GLS), and relative apical sparing (RELAPS) to identify ATTR-CA diagnosed using DPD-scintigraphy or abdominal fat biopsy. Results: PWT, RWT, RELAPS, troponin, and RWT/SaVR were significantly higher in ATTR-CA compared to LVH. RWT/SaVR > 0.7 was the most accurate parameter to identify ATTR-CA (sensitivity 97%, specificity 90% and accuracy 91%). RELAPS was found to have much less accuracy (sensitivity 74%, specificity 76% and accuracy 73%). Conclusion: We can confirm the very strong diagnostic accuracy of RWT/SaVR to identify ATTR-CA in patients with septal thickness > 14 mm. Given its high sensitivity and specificity, RWT/SaVR > 0.7 has the potential to implement as a non-invasive, simple, and widely available diagnostic tool when screening for ATTR-CA. |
| first_indexed | 2024-03-09T03:19:04Z |
| format | Article |
| id | doaj.art-9825551ebe814c31a1485d11eb082674 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T03:19:04Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-9825551ebe814c31a1485d11eb0826742023-12-03T15:13:26ZengMDPI AGJournal of Clinical Medicine2077-03832022-07-011114412010.3390/jcm11144120RWT/SaVR—A Simple and Highly Accurate Measure Screening for Transthyretin Cardiac AmyloidosisElsa Arnberg0Per Eldhagen1Viktor Löfbacka2Ashwin Venkateshvaran3Björn Pilebro4Per Lindqvist5Department of Clinical Physiology, Surgical & Perioperative Sciences, Umea University, SE-901 85 Umea, SwedenCardiology Unit, Department of Medicine, Karolinska Institute, SE-171 77 Stockholm, SwedenDepartment of Clinical Physiology, Surgical & Perioperative Sciences, Umea University, SE-901 85 Umea, SwedenCardiology Unit, Department of Medicine, Karolinska Institute, SE-171 77 Stockholm, SwedenDepartment of Cardiology, Public Health and Clinical Medicine, Umea University, SE-901 85 Umea, SwedenDepartment of Clinical Physiology, Surgical & Perioperative Sciences, Umea University, SE-901 85 Umea, SwedenBackground: Cardiac amyloidosis is an underdiagnosed condition and simple methods for accurate diagnosis are warranted. We aimed to validate a novel, dual-modality approach to identify transthyretin cardiac amyloidosis (ATTR-CA), employing echocardiographic relative wall thickness (RWT), and ECG S-wave from aVR (SaVR), and compare its accuracy with conventional echocardiographic approaches. Material and methods: We investigated 102 patients with ATTR-CA and 65 patients with left ventricular hypertrophy (LVH), all with septal thickness > 14 mm. We validated the accuracy of echocardiographic measures, including RWT, RWT/SaVR, posterior wall thickness (PWT), LV mass index (LVMI), left atrial volume index (LAVI), global longitudinal strain (GLS), and relative apical sparing (RELAPS) to identify ATTR-CA diagnosed using DPD-scintigraphy or abdominal fat biopsy. Results: PWT, RWT, RELAPS, troponin, and RWT/SaVR were significantly higher in ATTR-CA compared to LVH. RWT/SaVR > 0.7 was the most accurate parameter to identify ATTR-CA (sensitivity 97%, specificity 90% and accuracy 91%). RELAPS was found to have much less accuracy (sensitivity 74%, specificity 76% and accuracy 73%). Conclusion: We can confirm the very strong diagnostic accuracy of RWT/SaVR to identify ATTR-CA in patients with septal thickness > 14 mm. Given its high sensitivity and specificity, RWT/SaVR > 0.7 has the potential to implement as a non-invasive, simple, and widely available diagnostic tool when screening for ATTR-CA.https://www.mdpi.com/2077-0383/11/14/4120cardiac amyloidosisECGleft ventricular hypertrophyrelative wall thicknesstransthyretin |
| spellingShingle | Elsa Arnberg Per Eldhagen Viktor Löfbacka Ashwin Venkateshvaran Björn Pilebro Per Lindqvist RWT/SaVR—A Simple and Highly Accurate Measure Screening for Transthyretin Cardiac Amyloidosis Journal of Clinical Medicine cardiac amyloidosis ECG left ventricular hypertrophy relative wall thickness transthyretin |
| title | RWT/SaVR—A Simple and Highly Accurate Measure Screening for Transthyretin Cardiac Amyloidosis |
| title_full | RWT/SaVR—A Simple and Highly Accurate Measure Screening for Transthyretin Cardiac Amyloidosis |
| title_fullStr | RWT/SaVR—A Simple and Highly Accurate Measure Screening for Transthyretin Cardiac Amyloidosis |
| title_full_unstemmed | RWT/SaVR—A Simple and Highly Accurate Measure Screening for Transthyretin Cardiac Amyloidosis |
| title_short | RWT/SaVR—A Simple and Highly Accurate Measure Screening for Transthyretin Cardiac Amyloidosis |
| title_sort | rwt savr a simple and highly accurate measure screening for transthyretin cardiac amyloidosis |
| topic | cardiac amyloidosis ECG left ventricular hypertrophy relative wall thickness transthyretin |
| url | https://www.mdpi.com/2077-0383/11/14/4120 |
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