title: Evaluation of Myocardial Strain in Patients With Amyloidosis Using Cardiac Magnetic Resonance Feature Tracking.
abstract: OBJECTIVE
  To study the use of cardiac magnetic resonance (CMR) feature tracking technique in evaluation of myocardial amyloidosis.
  
  
  METHODS
  CMR scans of 28 patients with biopsy proven myocardial amyloidosis and 35 controls were reviewed. Conventional short axis, vertical long axis, and 4-chamber cine steady-state free precession images from CMR scans were used to generate radial, circumferential, and longitudinal myocardial strain maps using feature tracking software. Global and regional peak radial, circumferential, and longitudinal strain values were computed.
  
  
  RESULTS
  There were significant decreases in radial, circumferential, and longitudinal strains in patients with myocardial amyloidosis globally and across layers (all P < 0.001). Strain was relatively preserved for the apex and most affected for the basal level. The area under the receiver operating characteristic curve for base peak radial, circumferential, and longitudinal strain 0.899, 0.884, and 0.866 and cut offs of 22.9, -13.3, and -10.9, respectively, were determined by receiver operating characteristic analysis. CMR feature tracking strain analysis of base-level strain parameters was able to differentiate patients with myocardial amyloidosis from those without myocardial amyloid with high sensitivity (82.5%) and specificity (82.9%) particularly for radial strain. The maximum sensitivity (89.3%) was achieved if any of the 3 parameters were abnormal, and the maximum specificity (88.6%) when all 3 parameters were abnormal.
  
  
  CONCLUSIONS
  Myocardial amyloidosis produces significant changes in regional and global strain parameters, and the peak radial and circumferential strain are the most affected at the basal layer.
authors.affiliation: Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR. Electronic address: tpandey@uams.edu.
authors.forename: Tarun
authors.initials: T
authors.lastname: Pandey
authors.affiliation: Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Sindhura
authors.initials: S
authors.lastname: Alapati
authors.affiliation: Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Vibhor
authors.initials: V
authors.lastname: Wadhwa
authors.affiliation: Department of Cardiology, University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Mohan M
authors.initials: MM
authors.lastname: Edupuganti
authors.affiliation: Department of Cardiology, University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Pooja
authors.initials: P
authors.lastname: Gurram
authors.affiliation: Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Shelly
authors.initials: S
authors.lastname: Lensing
authors.affiliation: Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Kedar
authors.initials: K
authors.lastname: Jambhekar
mesh_terms: D000686:Amyloidosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001706:Biopsy; D016022:Case-Control Studies; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012984:Software