Key result
Systemic amyloidosis with preserved EF was associated with significantly decreased global and regional systolic and diastolic strain parameters compared to healthy controls (P < 0.05).
Why the study?
Does two-dimensional speckle tracking echocardiography detect early impairment of cardiac function and asynchronization in patients with systemic amyloidosis and preserved ejection fraction compared to healthy controls?
Case-Control (n=68)
Does two-dimensional speckle tracking echocardiography detect early impairment of cardiac function and asynchronization in patients with systemic amyloidosis and preserved ejection fraction compared to healthy controls?
p-value: p=<0.05
Two-dimensional speckle tracking echocardiography can detect early systolic and diastolic dysfunction, as well as mechanical contraction disorder, in patients with systemic amyloidosis despite a preserved ejection fraction.
May support speckle-tracking strain for early detection in amyloidosis with preserved EF; hypothesis-generating and requires prospective validation before practice change.
AIMS: To observe the ventricular global and regional function of the patients with systemic amyloidosis using two-dimensional speckle tracking echocardiography. METHODS: The study enrolled 31 consecutive biopsy-proved patients with systemic amyloidosis who underwent echocardiographic examination and EF ≥ 55% and 37 age- and gender-matched healthy controls. We compared systolic strain and strain rate, diastolic strain rate, time to peak strain, peak delay time in longitudinal, radial, circumferential directions in 16 left ventricular segments. The global peak systolic longitudinal and radial strain of left ventricle, peak systolic longitudinal strain and strain rate, diastolic strain rate of right ventricular free wall were also compared. RESULTS: (1) Global peak systolic longitudinal strain (GPSLS), peak systolic longitudinal strain (PSLS) and strain rate (PSLSR), peak early diastolic longitudinal strain rate (PELSR) in 16 segments were decreased in case (P < 0.05). (2) Peak systolic radial strain and strain rate of inferoseptum and inferolateral at the level of papillary muscle were lower (P < 0.05), and peak early diastolic radial strain rate (PERSR) was reduced (P < 0.05). (3) Peak early diastolic circumferential strain rate was lower (P < 0.05). (4) Time to peak systolic longitudinal, radial, circumferential strain was longer, and peak delay time at the same level retarded (P < 0.05). (5) Into right ventricular wall, PSLS and PSLSR at mid-segment, and PSLSR, PELSR, peak atrial systolic longitudinal strain rate (PALSR) at basal were reduced (P < 0.05). (6) Inverse correlation between interventricular septum (IVS) thickness and GPSLS and GPSRS was found (P < 0.05). CONCLUSION: Systolic and diastolic dysfunction existed in systemic amyloidosis with preserved EF. Mechanical contraction disorder may be one reason for systolic dysfunction. GPLSR and GPRSR were negatively related to IVS thickness.
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Huang et al. (2015) conducted a case-control in Systemic amyloidosis with preserved ejection fraction (n=68). Systemic amyloidosis vs. Healthy controls was evaluated on Ventricular global and regional function (systolic and diastolic strain and strain rate) (p=<0.05). Systemic amyloidosis with preserved EF was associated with significantly decreased global and regional systolic and diastolic strain parameters compared to healthy controls (P < 0.05).
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