Effect of Combined Systolic and Diastolic Functional Parameter Assessment for Differentiation of Cardiac Amyloidosis From Other Causes of Concentric Left Ventricular Hypertrophy
Effect of Combined Systolic and Diastolic Functional Parameter Assessment for Differentiation of Cardiac Amyloidosis From Other Causes of Concentric Left Ventricular Hypertrophy
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DOI：
10.1161/circimaging.113.000683
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发表时间：
2013-11-01
影响因子：
7.5
通讯作者：
Weidemann, Frank
中科院分区：
文献类型：
--
作者：
Liu, Dan;Hu, Kai;Weidemann, Frank
背景：心脏淀粉样变性（CA）与其他原因引起的同心性左心室肥厚的鉴别仍然是一个临床挑战，特别是在疾病早期射血分数保留的患者。方法与结果连续肥厚合并CA、孤立性动脉高血压、Fabry病、friedrich共济失调患者（每组25例）；25名健康志愿者作为对照组。采用标准超声心动图，通过二维散斑跟踪成像评估室间隔节段性纵向收缩峰值应变（LSsys）。各组左室肥厚指标及射血分数相似。CA患者的早期充盈减速时间（14746毫秒）明显低于孤立性动脉高血压、Fabry病或对照组(所有P2.1将CA与其他原因的左室肥厚区分开来（敏感性88%；特异性85%；阳性预测值67%；阴性预测值96%）。鼻中隔顶基LSsys比值>2.1 +早期充盈减速时间2.1)，合并早期充盈舒张期减速时间缩短（早期充盈减速时间）
Background Differentiation of cardiac amyloidosis (CA) from other causes of concentric left ventricular hypertrophy remains a clinical challenge, especially in patients with preserved ejection fraction at the early disease stages.Methods and Results Consecutive hypertrophic patients with CA, isolated arterial hypertension, Fabry disease, and Friedreich ataxia (n=25 per group) were investigated; 25 healthy volunteers served as a control group. Standard echocardiography was performed, and segmental longitudinal peak systolic strain (LSsys) in the septum was assessed by 2-dimensional speckle tracking imaging. Indices of left ventricular hypertrophy and ejection fraction were similar among all patient groups. Deceleration time of early filling was significantly lower in patients with CA (14746 milliseconds) compared with those with isolated arterial hypertension, Fabry disease, or control subjects (all P2.1 differentiated CA from other causes of left ventricular hypertrophy (sensitivity, 88%; specificity, 85%; positive predictive value, 67%; negative predictive value, 96%). The prevalence of septal apical to basal LSsys ratio >2.1 plus deceleration time of early filling 2.1), combined with a shortened diastolic deceleration time of early filling (deceleration time of early filling