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Utility of left atrial and ventricular strain for diagnosis of transthyretin amyloid cardiomyopathy in aortic stenosis
AIMS: To clarify the usefulness of left atrial (LA) function and left ventricular (LV) function obtained by two‐dimensional (2D) speckle tracking echocardiography to diagnose concomitant transthyretin amyloid cardiomyopathy (ATTR‐CM) in patients with aortic stenosis (AS). METHODS AND RESULTS: We ana...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9065867/ https://www.ncbi.nlm.nih.gov/pubmed/35338611 http://dx.doi.org/10.1002/ehf2.13909 |
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author | Oike, Fumi Usuku, Hiroki Yamamoto, Eiichiro Marume, Kyohei Takashio, Seiji Ishii, Masanobu Tabata, Noriaki Fujisue, Koichiro Yamanaga, Kenshi Sueta, Daisuke Hanatani, Shinsuke Arima, Yuichiro Araki, Satoshi Oda, Seitaro Kawano, Hiroaki Soejima, Hirofumi Matsushita, Kenichi Ueda, Mitsuharu Fukui, Toshihiro Tsujita, Kenichi |
author_facet | Oike, Fumi Usuku, Hiroki Yamamoto, Eiichiro Marume, Kyohei Takashio, Seiji Ishii, Masanobu Tabata, Noriaki Fujisue, Koichiro Yamanaga, Kenshi Sueta, Daisuke Hanatani, Shinsuke Arima, Yuichiro Araki, Satoshi Oda, Seitaro Kawano, Hiroaki Soejima, Hirofumi Matsushita, Kenichi Ueda, Mitsuharu Fukui, Toshihiro Tsujita, Kenichi |
author_sort | Oike, Fumi |
collection | PubMed |
description | AIMS: To clarify the usefulness of left atrial (LA) function and left ventricular (LV) function obtained by two‐dimensional (2D) speckle tracking echocardiography to diagnose concomitant transthyretin amyloid cardiomyopathy (ATTR‐CM) in patients with aortic stenosis (AS). METHODS AND RESULTS: We analysed 72 consecutive patients with moderate to severe AS who underwent (99m)Tc‐pyrophosphate (PYP) scintigraphy at Kumamoto University Hospital from January 2012 to September 2020. We divided these 72 patients into 2 groups based on their (99m)Tc‐PYP scintigraphy positivity or negativity. Among 72 patients, 16 patients (22%) were positive, and 56 patients (78%) were negative for (99m)Tc‐PYP scintigraphy. In clinical baseline characteristics, natural logarithm troponin T was significantly higher in the (99m)Tc‐PYP scintigraphy‐positive than scintigraphy‐negative group (−2.9 ± 0.5 vs. −3.5 ± 0.8 ng/mL, P < 0.05). In conventional echocardiography, the severity of AS was not significantly different between these two groups. In 2D speckle tracking echocardiography, the relative apical longitudinal strain (LS) index (RapLSI) [apical LS/ (basal LS + mid LS)] was significantly higher (1.09 ± 0.49 vs. 0.78 ± 0.23, P < 0.05) and the peak longitudinal strain rate (LSR) in LA was significantly lower in the (99m)Tc‐PYP scintigraphy‐positive than scintigraphy‐negative group (0.36 ± 0.14 vs. 0.55 ± 0.20 s(−1), P < 0.05). Multivariable logistic analysis revealed the peak LSR in LA and RapLSI were significantly associated with (99m)Tc‐PYP scintigraphy positivity. Receiver operating characteristic analysis showed that the area under the curve (AUC) of the peak LSR in LA for (99m)Tc‐PYP scintigraphy positivity was 0.79 and that the best cut‐off value of the peak LSR in LA was 0.47 s(−1) (sensitivity: 78.6% and specificity: 72.3%). The AUC of RapLSI for (99m)Tc‐PYP scintigraphy positivity was 0.69, and the cut‐off value of RapLSI was decided as 1.00 (sensitivity: 43.8% and specificity: 87.5%) according to the previous report. The (99m)Tc‐PYP scintigraphy positivity in patients with RapLSI ≥ 1.0 and the peak LSR in LA ≤ 0.47 s(−1) was 83.3% (5/6), and the (99m)Tc‐PYP scintigraphy negativity in patients with RapLSI < 1.0 and the peak LSR in LA > 0.47 s(−1) was 96.6% (28/29). CONCLUSIONS: Left atrial and LV strain analysis were significantly associated with (99m)Tc‐PYP scintigraphy positivity in ATTR‐CM patients with moderate to severe AS. The combination of the peak LSR in LA and RapLSI might be a useful predictor of the presence of ATTR‐CM in patients with moderate to severe AS. |
format | Online Article Text |
id | pubmed-9065867 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-90658672022-05-04 Utility of left atrial and ventricular strain for diagnosis of transthyretin amyloid cardiomyopathy in aortic stenosis Oike, Fumi Usuku, Hiroki Yamamoto, Eiichiro Marume, Kyohei Takashio, Seiji Ishii, Masanobu Tabata, Noriaki Fujisue, Koichiro Yamanaga, Kenshi Sueta, Daisuke Hanatani, Shinsuke Arima, Yuichiro Araki, Satoshi Oda, Seitaro Kawano, Hiroaki Soejima, Hirofumi Matsushita, Kenichi Ueda, Mitsuharu Fukui, Toshihiro Tsujita, Kenichi ESC Heart Fail Original Articles AIMS: To clarify the usefulness of left atrial (LA) function and left ventricular (LV) function obtained by two‐dimensional (2D) speckle tracking echocardiography to diagnose concomitant transthyretin amyloid cardiomyopathy (ATTR‐CM) in patients with aortic stenosis (AS). METHODS AND RESULTS: We analysed 72 consecutive patients with moderate to severe AS who underwent (99m)Tc‐pyrophosphate (PYP) scintigraphy at Kumamoto University Hospital from January 2012 to September 2020. We divided these 72 patients into 2 groups based on their (99m)Tc‐PYP scintigraphy positivity or negativity. Among 72 patients, 16 patients (22%) were positive, and 56 patients (78%) were negative for (99m)Tc‐PYP scintigraphy. In clinical baseline characteristics, natural logarithm troponin T was significantly higher in the (99m)Tc‐PYP scintigraphy‐positive than scintigraphy‐negative group (−2.9 ± 0.5 vs. −3.5 ± 0.8 ng/mL, P < 0.05). In conventional echocardiography, the severity of AS was not significantly different between these two groups. In 2D speckle tracking echocardiography, the relative apical longitudinal strain (LS) index (RapLSI) [apical LS/ (basal LS + mid LS)] was significantly higher (1.09 ± 0.49 vs. 0.78 ± 0.23, P < 0.05) and the peak longitudinal strain rate (LSR) in LA was significantly lower in the (99m)Tc‐PYP scintigraphy‐positive than scintigraphy‐negative group (0.36 ± 0.14 vs. 0.55 ± 0.20 s(−1), P < 0.05). Multivariable logistic analysis revealed the peak LSR in LA and RapLSI were significantly associated with (99m)Tc‐PYP scintigraphy positivity. Receiver operating characteristic analysis showed that the area under the curve (AUC) of the peak LSR in LA for (99m)Tc‐PYP scintigraphy positivity was 0.79 and that the best cut‐off value of the peak LSR in LA was 0.47 s(−1) (sensitivity: 78.6% and specificity: 72.3%). The AUC of RapLSI for (99m)Tc‐PYP scintigraphy positivity was 0.69, and the cut‐off value of RapLSI was decided as 1.00 (sensitivity: 43.8% and specificity: 87.5%) according to the previous report. The (99m)Tc‐PYP scintigraphy positivity in patients with RapLSI ≥ 1.0 and the peak LSR in LA ≤ 0.47 s(−1) was 83.3% (5/6), and the (99m)Tc‐PYP scintigraphy negativity in patients with RapLSI < 1.0 and the peak LSR in LA > 0.47 s(−1) was 96.6% (28/29). CONCLUSIONS: Left atrial and LV strain analysis were significantly associated with (99m)Tc‐PYP scintigraphy positivity in ATTR‐CM patients with moderate to severe AS. The combination of the peak LSR in LA and RapLSI might be a useful predictor of the presence of ATTR‐CM in patients with moderate to severe AS. John Wiley and Sons Inc. 2022-03-25 /pmc/articles/PMC9065867/ /pubmed/35338611 http://dx.doi.org/10.1002/ehf2.13909 Text en © 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Oike, Fumi Usuku, Hiroki Yamamoto, Eiichiro Marume, Kyohei Takashio, Seiji Ishii, Masanobu Tabata, Noriaki Fujisue, Koichiro Yamanaga, Kenshi Sueta, Daisuke Hanatani, Shinsuke Arima, Yuichiro Araki, Satoshi Oda, Seitaro Kawano, Hiroaki Soejima, Hirofumi Matsushita, Kenichi Ueda, Mitsuharu Fukui, Toshihiro Tsujita, Kenichi Utility of left atrial and ventricular strain for diagnosis of transthyretin amyloid cardiomyopathy in aortic stenosis |
title | Utility of left atrial and ventricular strain for diagnosis of transthyretin amyloid cardiomyopathy in aortic stenosis |
title_full | Utility of left atrial and ventricular strain for diagnosis of transthyretin amyloid cardiomyopathy in aortic stenosis |
title_fullStr | Utility of left atrial and ventricular strain for diagnosis of transthyretin amyloid cardiomyopathy in aortic stenosis |
title_full_unstemmed | Utility of left atrial and ventricular strain for diagnosis of transthyretin amyloid cardiomyopathy in aortic stenosis |
title_short | Utility of left atrial and ventricular strain for diagnosis of transthyretin amyloid cardiomyopathy in aortic stenosis |
title_sort | utility of left atrial and ventricular strain for diagnosis of transthyretin amyloid cardiomyopathy in aortic stenosis |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9065867/ https://www.ncbi.nlm.nih.gov/pubmed/35338611 http://dx.doi.org/10.1002/ehf2.13909 |
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