Key result
Cardiac amyloidosis is linked to ~51% lower reservoir left atrial strain compared to HCM.
Why the study?
To evaluate MRI-assessed left atrial strain and left atrial strain rate for diagnosing cardiac amyloidosis, distinguishing clinical subtypes, and differentiating from other cardiomyopathies.
Does MRI-assessed left atrial strain and strain rate help diagnose cardiac amyloidosis and differentiate it from hypertrophic cardiomyopathy?
Observational (n=110)
No
Does MRI-assessed left atrial strain and strain rate help diagnose cardiac amyloidosis and differentiate it from hypertrophic cardiomyopathy?
Absolute Event Rate: 8.3% vs 16.8%
p-value: p=<0.001
MRI-assessed left atrial strain and strain rate are severely impaired in cardiac amyloidosis and may serve as non-invasive parameters to differentiate it from hypertrophic cardiomyopathy.
Impaired left atrial strain may aid differentiation of cardiac amyloidosis from hypertrophic cardiomyopathy; leaves open prospective diagnostic validation.
Aims: The present study aims to evaluate magnetic-resonance-imaging (MRI)-assessed left atrial strain (LAS) and left atrial strain rate (LASR) as potential parameters for the diagnosis of cardiac amyloidosis (CA), the distinction of clinical subtypes and differentiation from other cardiomyopathies. Methods and results: LAS and LASR were assessed by MRI feature tracking in patients with biopsy-proven CA. LAS and LASR of patients with CA were compared to healthy subjects and patients with hypertrophic cardiomyopathy. LAS and LASR were also analyzed concerning differences between patients with transthyretin (ATTR) and light chain amyloidosis (AL). A total of 44 patients with biopsy-proven CA, 19 patients with hypertrophic cardiomyopathy and 24 healthy subjects were included. In 22 CA patients (50%), histological examination identified ATTR as CA subtype and AL in the remaining patients. No significant difference was observed for reservoir, conduit or booster LAS in patients with AL or ATTR. Reservoir LAS, conduit LAS and booster LAS were significantly reduced in patients with CA and HCM as compared to healthy subjects (p < 0.001). Reservoir LAS and booster LAS were significantly reduced in CA as compared to HCM patients (p < 0.001). A linear correlation was observed between LA global reservoir strain and LA-EF (p < 0.001, r = 0.5), conduit strain and global longitudinal LV strain (p < 0.001, r = 0.5), global booster strain rate and LA-EF (p < 0.001, r = 0.6) and between global booster strain rate and LA area at LVED (p < 0.0001, 0.5). Conclusions: LAS and LASR are severely impaired in patients with CA. The MRI-based assessment of LAS and LASR might allow non-invasive diagnosis and categorization of CA and its distinct differentiation from other hypertrophic phenotypes.
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Sciacca et al. (2022) conducted an observational in Cardiac amyloidosis (n=110). Cardiac amyloidosis vs. Hypertrophic cardiomyopathy and healthy subjects was evaluated on Reservoir left atrial strain (LAS) (p=<0.001). MRI-assessed reservoir and booster left atrial strain were significantly reduced in patients with cardiac amyloidosis compared to patients with hypertrophic cardiomyopathy (p < 0.001).
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