title: Disease-specific differences of left ventricular rotational mechanics between cardiac amyloidosis and hypertrophic cardiomyopathy.
abstract: Left ventricular (LV) twist (LVT) and untwisting (LVUT) rate are global and thorough parameters of LV function. The aim of the present study was to investigate the differences in LV rotational mechanics between patients with cardiac amyloidosis (CA) and hypertrophic cardiomyopathy (HCM). Twenty consecutive patients with CA, 20 consecutive patients with HCM, and 20 consecutive subjects without evidence of structural heart disease were included. Cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE) imaging was performed to evaluate biventricular function, LV mass index, and presence/extent of LGE. Feature-tracking analysis was applied to LV basal and apical short-axis images to determine peak LVT, time to peak LVT, peak LVUT rate, and time to peak LVUT rate. Peak LVT and peak LVUT rate were significantly impaired in patients with CA compared with controls (P < 0.05 for both). In patients with HCM, peak LVT was increased (P < 0.05) compared with controls, whereas peak LVUT rate was preserved (P > 0.05). Time to peak LVUT rate was significantly prolonged in patients with CA and in patients with HCM compared with controls (ANOVA P < 0.001). At multivariate analysis, age (P = 0.007), LV ejection fraction (P = 0.035) and extent of LGE (P < 0.001) were independently related to peak LVT, and LV mass index (P = 0.015) and extent of LGE (P = 0.004) were independently related to peak LVUT rate, whereas extent of LGE (P < 0.001) was the only variable independently related to time to peak LVUT rate. In conclusion, CA and HCM have specific behavior of LV rotational mechanics. The extent of LGE significantly influences the LV rotational mechanics.
authors.affiliation: Cardiothoracic Department and gnucifora@cardionet.it.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Nucifora
authors.affiliation: Cardiothoracic Department and Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy;
authors.forename: Daniele
authors.initials: D
authors.lastname: Muser
authors.affiliation: Cardiothoracic Department and.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Morocutti
authors.affiliation: Department of Diagnostic Imaging, University Hospital Santa Maria della Misericordia, Udine, Italy;
authors.forename: Gianluca
authors.initials: G
authors.lastname: Piccoli
authors.affiliation: Cardiothoracic Department and.
authors.forename: Davide
authors.initials: D
authors.lastname: Zanuttini
authors.affiliation: Cardiothoracic Department and.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Gianfagna
authors.affiliation: Cardiothoracic Department and I.R.C.A.B. Foundation, Udine, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Proclemer
mesh_terms: D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000473:pathology / Q000503:physiopathology*; D002312:Cardiomyopathy, Hypertrophic / Q000473:pathology / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012399:Rotation; D016277:Ventricular Function, Left
keywords: cardiac amyloidosis; cardiac magnetic resonance; feature-tracking; hypertrophic cardiomyopathy; rotational mechanics