Does relative apical sparing (RASP) occur in severe symptomatic aortic stenosis without amyloidosis, and is it reversible after surgical aortic valve replacement?
Relative apical sparing on imaging is not pathognomonic for cardiac amyloidosis and can occur in severe aortic stenosis, where it reflects advanced LV disease that is largely reversible following surgical valve replacement.
RASP is not specific of cardiac amyloidosis. It may also be found in severe symptomatic AS without amyloidosis, reflecting advanced LV disease, being mostly reversible after surgery.
Abecasis et al. (Sun,) studied this question.