Evidence of impaired left ventricular systolic function by Doppler myocardial Imaging in patients with systemic amyloidosis and no evidence of cardiac involvement by standard two-dimensional and Doppler echocardiography
Evidence of impaired left ventricular systolic function by Doppler myocardial Imaging in patients with systemic amyloidosis and no evidence of cardiac involvement by standard two-dimensional and Doppler echocardiography
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DOI：
10.1016/j.amjcard.2007.11.047
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发表时间：
2008-04-01
影响因子：
2.8
通讯作者：
Miller, Fletcher A., Jr.
中科院分区：
文献类型：
--
作者：
Bellavia, Diego;Pellikka, Patricia A.;Miller, Fletcher A., Jr.
我们研究了多普勒心肌成像在系统性淀粉样变性（AL）患者早期发现收缩功能障碍的潜在作用，但没有标准超声心动图显示心脏受累的证据。我们确定了42例无二维超声心动图或多普勒心脏受累证据的患者。这些患者心室壁厚度正常，二尖瓣内侧环流速正常。在这些患者和32名年龄和性别匹配的健康对照中获得心肌图像。测定16个左心室节段的峰值纵向收缩组织速度（sTVI）、收缩应变率（sSR）和收缩应变（sS）。同时测定了径向和周向sSR和sS。与对照组相比，这组AL患者的峰值纵向sSR （- 1.0 +/- 0.2 vs - 1.4 +/- 0.2, p < 0.001）和峰值纵向sS （-15.6 +/- 3.3 vs -22.5:+/- 2.0 p < 0.001）显著降低。综上所述，超声心动图正常的AL患者通过所有6个基底节段的平均sS或所有16个左心室节段的平均sS与对照组相区分，6个基底节段的平均sSR具有相似的准确性。这种区别在峰值纵向sTVI或径向或周向sSI或sSR上并不明显。(C) 2008爱思唯尔公司
We examined the potential role of Doppler myocardial imaging for early detection of systolic dysfunction in patients with systemic amyloidosis (AL) but without evidence of cardiac involvement by standard echocardiography. We identified 42 patients without 2-dimensional echocardiographic or Doppler evidence of cardiac involvement. These patients had normal ventricular wall thickness and normal velocity of the medial mitral annulus. Myocardial images were obtained in these patients and in 32 age- and gender-matched healthy controls. Peak longitudinal systolic tissue velocity (sTVI), systolic strain rate (sSR), and systolic strain (sS) were determined for 16 left ventricular segments. Radial and circumferential sSR and sS were also measured. Compared with controls in this group of patients with AL, peak longitudinal sSR (- 1.0 +/- 0.2 vs - 1.4 +/- 0.2, p < 0.001) and peak longitudinal sS (-15.6 +/- 3.3 vs -22.5 :+/- 2.0 p < 0.001) were significantly decreased. In conclusion, the mean sS from all 6 basal segments, or from all 16 left ventricular segments differentiated patients with AL with normal echocardiography from controls, with similar accuracy for the mean sSR from the 6 basal segments. This distinction was not apparent from peak longitudinal sTVI or from radial or circumferential sSI or sSR. (C) 2008 Elsevier Inc.