Tissue Doppler and strain imaging: a new tool for early detection of cardiac amyloidosis.
Using traditional echocardiography, the diagnosis of cardiac amyloidosis (CA) is often only possible in advanced stage when recommended therapies may have adverse effects. The aim of our study was to evaluate whether additional information can be derived from Tissue and strain Doppler imaging (TDI and SDI). Forty patients with systemic amyloidosis and 24 healthy subjects underwent traditional, tissue and strain Doppler echocardiography. Patients were classified having CA if mean wall thickness (mT), was half of the sum septum and posterior wall thickness, was > or =12 mm. The following parameters were evaluated: peak early diastolic velocity (Em) as index of ventricular relaxation, mitral E-wave to Em ratio (E/Em) as index of left ventricular (LV) filling pressure and mean LV strain peak curves (mSt) as global long-axis contraction index. In non cardiac amyloidosis (NCA), both Em and mSt were lower than in age matched controls (p < 0.01, p < 0.05, respectively) and higher than in CA (p < 0.01 and p < 0.01, respectively). Both Em and mSt were related to mT (p < 0.001). A significant (p < 0.01) nonlinear relation was observed between plasma terminal of pro B-natriuretic peptide and mT, Em, E/Em and mSt. TDI and SDI are able to detect amyloid myocardial involvement in such an early stage that cannot be evidenced by using traditional echocardiography.
Porciani
Maria Cristina
MC
Department of Medical and Surgical Critical Care, University of Florence, Florence, Italy. cporciani@hotmail.com
Lilli
Alessio
A
Perfetto
Federico
F
Cappelli
Francesco
F
Massimiliano Rao
Carmelo
C
Del Pace
Stefano
S
Ciaccheri
Mauro
M
Castelli
Gabriele
G
Tarquini
Roberto
R
Romagnani
Lara
L
Pastorini
Tiziana
T
Padeletti
Luigi
L
Bergesio
Franco
F
D000368:Aged; D000686:Amyloidosis / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D042241:Early Diagnosis; D015150:Echocardiography, Doppler; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male