Rationale and Objectives
Strain measured by feature tracking technique represents the degree of deformation
and reflects the systolic and diastolic function of the heart. Our purpose was to
evaluate the differential diagnostic value and correlations of left atrial (LA) strain
(LAS) and left ventricular (LV) strain (LVS) in cardiac amyloidosis (CA) and hypertensive
heart disease (HHD) patients.
Materials and Methods
We recruited 25 CA patients, 30 sex- and age-matched HHD patients and 20 healthy subjects
totally. LAS and LVS were analyzed by CVI42 post-processing software. The efficiency
of LAS and LVS in differentiating CA from HHD was compared by receiver operating characteristic
curves analysis. Pearson or Spearman's analysis were used to assess the correlation
between LAS and LV parameters.
Results
Both HHD and CA patients had impaired LVS, the gradient of increasing absolute values
of longitudinal strain (LS) and radial strain (RS) from the basal to the apical myocardium
was most pronounced in the CA group, its relative apical sparing of LS (RASLS) ratio reached 0.91 ± 0.02, significantly higher than other two groups (HHD: 0.72
± 0.02; controls: 0.56 ± 0.01, all p <0.001). Additionally, except for the booster strain in the HHD group was preserved,
all other LAS were reduced in patients’ groups. The RASLS had the best differential diagnostic efficacy with an area under the curve (AUC)
of 0.930 (p <0.001); The AUCs of LAS all greater than 0.850, above global LS (GLS) (AUC = 0.770,
p = 0.001). LAS was notably correlated with LV ejection fraction (LVEF) and GLS, with
reservoir strain having the greatest correlation with GLS (r = -0.828, p <0.001).
Conclusion
The RASLS has high efficiency in guiding the differential diagnosis of CA and HHD with similar
degree and presentation of LVH. Moreover, LAS values can also provide some useful
information and they are closely linked with LV function, CMR feature tracking may
provide assistance in the evaluation of LA-LV coupling.
Key Words
Abbreviations:
ACS (Apical Circumferential Strain), ALS (Apical Longitudinal Strain), ARS (Apical Radial Strain), AUC (Area Under the Curve), BCS (Basal Circumferential Strain), BLS (Basal Longitudinal Strain), BRS (Basal Radial Strain), CA (Cardiac Amyloidosis), CMR (Cardiac Magnetic Resonance), CS (Circumferential Strain), ECV (Extracellular Volume), FT (Feature Tracking), GCS (Global Circumferential Strain), GLS (Global Longitudinal Strain), GRS (Global Radial Strain), HHD (Hypertensive Heart Disease), LA (Left Atrium), LAS (Left Atrial Strain), LVEDVI (Left Ventricular End-Diastolic Volume Index), LVEF (Left Ventricular Ejection Fraction), LVESVI (Left Ventricular End-Systolic Volume Index), LVH (Left ventricular Hypertrophy), LVMI (Left Ventricular Mass Index), LS (Longitudinal Strain), LV (Left Ventricle), LVS (Left Ventricular Strain), MCS (Middle Circumferential Strain), MLS (Middle Longitudinal Strain), MRS (Middle Radial Strain), RAS (Relative Apical Sparing), ROC (Receiver Operating Characteristic), RS (Radial Strain)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 15, 2023
Accepted:
February 1,
2023
Received in revised form:
January 30,
2023
Received:
December 6,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
