title: Three-dimensional Speckle Tracking Echocardiography in Light Chain Cardiac Amyloidosis: Examination of Left and Right Ventricular Myocardial Mechanics Parameters.
abstract: OBJECTIVE
  The study of myocardial mechanics has a potential role in the detection of cardiac involvement in patients with amyloidosis. This study aimed to characterize 3-dimensional-speckle tracking echocardiography-derived left and right ventricular myocardial mechanics in light chain amyloidosis and examine their relationship with brain natriuretic peptide.
  
  
  METHODS
  In patients with light chain amyloidosis, left ventricular longitudinal and circumferential strain (n=40), and right ventricular longitudinal strain and radial displacement (n=26) were obtained by 3-dimensional-speckle tracking echocardiography. Brain natriuretic peptide levels were determined.
  
  
  RESULTS
  All myocardial mechanics measurements showed differences when compared by brain natriuretic peptide level tertiles. Left and right ventricular longitudinal strain were highly correlated (r=0.95, P<.001). Left ventricular longitudinal and circumferential strain were reduced in patients with cardiac involvement (-9±4 vs -16±2; P<.001, and -24±6 vs -29±4; P=.01, respectively), with the most prominent impairment at the basal segments. Right ventricular longitudinal strain and radial displacement were diminished in patients with cardiac involvement (-9±3 vs -17±3; P<.001, and 2.7±0.8 vs 3.8±0.3; P=.002). On multivariate analysis, left ventricular longitudinal strain was associated with the presence of cardiac involvement (odds ratio = 1.6; 95% confidence interval, 1.04 to 2.37; P=.03) independent of the presence of brain natriuretic peptide and troponin I criteria for cardiac amyloidosis.
  
  
  CONCLUSIONS
  Three-dimensional-speckle tracking echocardiography-derived left and right ventricular myocardial mechanics are increasingly altered as brain natriuretic peptide increases in light chain amyloidosis. There appears to be a strong association between left ventricular longitudinal strain and cardiac involvement, beyond biomarkers such as brain natriuretic peptide and troponin I.
authors.affiliation: Cardiovascular Imaging and Hemodynamic Laboratory, Tufts Medical Center, Boston Massachusetts, United States. Electronic address: jaurbanomoral@gmail.com.
authors.forename: Jose Angel
authors.initials: JA
authors.lastname: Urbano-Moral
authors.affiliation: Cardiovascular Imaging and Hemodynamic Laboratory, Tufts Medical Center, Boston Massachusetts, United States.
authors.forename: Dakshin
authors.initials: D
authors.lastname: Gangadharamurthy
authors.affiliation: Cardiovascular Imaging and Hemodynamic Laboratory, Tufts Medical Center, Boston Massachusetts, United States.
authors.forename: Raymond L
authors.initials: RL
authors.lastname: Comenzo
authors.affiliation: Cardiovascular Imaging and Hemodynamic Laboratory, Tufts Medical Center, Boston Massachusetts, United States.
authors.forename: Natesa G
authors.initials: NG
authors.lastname: Pandian
authors.affiliation: Cardiovascular Imaging and Hemodynamic Laboratory, Tufts Medical Center, Boston Massachusetts, United States.
authors.forename: Ayan R
authors.initials: AR
authors.lastname: Patel
mesh_terms: D000686:Amyloidosis / Q000175:diagnosis* / Q000503:physiopathology; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000503:physiopathology; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D011446:Prospective Studies; D015203:Reproducibility of Results; D016277:Ventricular Function, Left / Q000502:physiology*; D016278:Ventricular Function, Right / Q000502:physiology*
keywords: Amiloidosis; Amyloidosis; Ecocardiografía speckle tracking; Ecocardiografía tridimensional; Right ventricle; Speckle tracking echocardiography; Three-dimensional echocardiography; Ventrículo derecho