CMR-based right ventricular strain analysis in cardiac amyloidosis and its potential as a supportive diagnostic feature
Background: Right ventricular (RV) strain has provided valuable prognostic information for patients with 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 exacerba...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-02-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906722002160 |
| _version_ | 1828042099469058048 |
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| author | Jan Eckstein Hermann Körperich Elena Weise Valdés Vanessa Sciacca Lech Paluszkiewicz Wolfgang Burchert Martin Farr Philipp Sommer Christian Sohns Misagh Piran |
| author_facet | Jan Eckstein Hermann Körperich Elena Weise Valdés Vanessa Sciacca Lech Paluszkiewicz Wolfgang Burchert Martin Farr Philipp Sommer Christian Sohns Misagh Piran |
| author_sort | Jan Eckstein |
| collection | DOAJ |
| description | Background: Right ventricular (RV) strain has provided valuable prognostic information for patients with 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. Aims: Evaluation of cardiac magnetic resonance (CMR) quantified RV global and regional strain of CA and HCM patients along with CA subtypes. 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 diagnostic performance and discriminatory power between the different clinical entities. Results: Effective differentiation of CA from HCM patients was achieved utilizing global longitudinal (GLS: 16.5 ± 3.9% vs. −21.3 ± 6.7%, p = 0.032), radial (GRS: 11.7 ± 5.3% vs. 16.5 ± 7.1%, p < 0.001) and circumferential (GCS: -7.6 ± 4.0% vs. −9.4 ± 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 ventricular ejection fraction (RV-EF) (p = 0.017) to be a significant predictor of CA-HCM differentiation. CA subtypes had comparable cardiac strains. 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. |
| first_indexed | 2024-04-10T17:26:07Z |
| format | Article |
| id | doaj.art-996d8f845ed441a7b1177178167bfad9 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-04-10T17:26:07Z |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-996d8f845ed441a7b1177178167bfad92023-02-04T04:18:04ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672023-02-0144101167CMR-based right ventricular strain analysis in cardiac amyloidosis and its potential as a supportive diagnostic featureJan Eckstein0Hermann Körperich1Elena Weise Valdés2Vanessa Sciacca3Lech Paluszkiewicz4Wolfgang Burchert5Martin Farr6Philipp Sommer7Christian Sohns8Misagh Piran9Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, Bad Oeynhausen, University of Bochum, GermanyInstitute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, Bad Oeynhausen, University of Bochum, Germany; Corresponding author at: Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Institut für Radiologie, Nuklearmedizin und Molekulare Bildgebung, Georgstr. 11, 32545 Bad Oeynhausen, Germany.Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, Bad Oeynhausen, University of Bochum, GermanyClinic for Electrophysiology, Heart and Diabetes Center North Rhine Westphalia, Bad Oeynhausen, University of Bochum, GermanyClinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, GermanyInstitute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, Bad Oeynhausen, University of Bochum, GermanyCardiogenetic Laboratory, Heart and Diabetes Center North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, GermanyClinic for Electrophysiology, Heart and Diabetes Center North Rhine Westphalia, Bad Oeynhausen, University of Bochum, GermanyClinic for Electrophysiology, Heart and Diabetes Center North Rhine Westphalia, Bad Oeynhausen, University of Bochum, GermanyInstitute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, Bad Oeynhausen, University of Bochum, GermanyBackground: Right ventricular (RV) strain has provided valuable prognostic information for patients with 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. Aims: Evaluation of cardiac magnetic resonance (CMR) quantified RV global and regional strain of CA and HCM patients along with CA subtypes. 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 diagnostic performance and discriminatory power between the different clinical entities. Results: Effective differentiation of CA from HCM patients was achieved utilizing global longitudinal (GLS: 16.5 ± 3.9% vs. −21.3 ± 6.7%, p = 0.032), radial (GRS: 11.7 ± 5.3% vs. 16.5 ± 7.1%, p < 0.001) and circumferential (GCS: -7.6 ± 4.0% vs. −9.4 ± 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 ventricular ejection fraction (RV-EF) (p = 0.017) to be a significant predictor of CA-HCM differentiation. CA subtypes had comparable cardiac strains. 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.http://www.sciencedirect.com/science/article/pii/S2352906722002160Cardiovascular magnetic resonance imagingCardiac amyloidosisHypertrophic phenotypeGlobal and regional strainAmyloidosis subtypes |
| spellingShingle | Jan Eckstein Hermann Körperich Elena Weise Valdés Vanessa Sciacca Lech Paluszkiewicz Wolfgang Burchert Martin Farr Philipp Sommer Christian Sohns Misagh Piran CMR-based right ventricular strain analysis in cardiac amyloidosis and its potential as a supportive diagnostic feature International Journal of Cardiology: Heart & Vasculature Cardiovascular magnetic resonance imaging Cardiac amyloidosis Hypertrophic phenotype Global and regional strain Amyloidosis subtypes |
| title | CMR-based right ventricular strain analysis in cardiac amyloidosis and its potential as a supportive diagnostic feature |
| title_full | CMR-based right ventricular strain analysis in cardiac amyloidosis and its potential as a supportive diagnostic feature |
| title_fullStr | CMR-based right ventricular strain analysis in cardiac amyloidosis and its potential as a supportive diagnostic feature |
| title_full_unstemmed | CMR-based right ventricular strain analysis in cardiac amyloidosis and its potential as a supportive diagnostic feature |
| title_short | CMR-based right ventricular strain analysis in cardiac amyloidosis and its potential as a supportive diagnostic feature |
| title_sort | cmr based right ventricular strain analysis in cardiac amyloidosis and its potential as a supportive diagnostic feature |
| topic | Cardiovascular magnetic resonance imaging Cardiac amyloidosis Hypertrophic phenotype Global and regional strain Amyloidosis subtypes |
| url | http://www.sciencedirect.com/science/article/pii/S2352906722002160 |
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