Influence of Ventricular Wringing on the Preservation of Left Ventricular Ejection Fraction in Cardiac Amyloidosis
Por:
Mora V, Roldán I, Bertolín J, Faga V, Pérez-Gil MDM, Saad A, Serrats R, Callizo R, Arbucci R and Lowenstein J
Publicada:
1 jul 2021
Ahead of Print:
1 jul 2021
Categoría:
Cardiology and cardiovascular medicine
Resumen:
Background: The purpose of this work was to determine the influence of myocardial wringing on ventricular function in patients with cardiac amyloidosis (CA).
Methods: Fifteen healthy volunteers (group 1) and 34 patients with CA (17 with left ventricular ejection fractions [LVEFs] >= 53% [group 2] and 17 with LVEFs < 53% [group 3]) were evaluated using two-dimensional speckletracking echocardiography. A control group of mass-matched patients (n = 20) with left ventricular (LV) hypertrophy and LVEFs >= 53% was also included. Longitudinal strain (LS), circumferential strain, and LV twist and torsion were calculated. Deformation index (DefI), a new parameter of wringing, calculated as twist/LS, that takes into account actions that occur simultaneously during LV systole (i.e., longitudinal shortening and twist), was evaluated. Torsional and wringing parameters were calculated according to LVEF.
Results: Lower global values of LS and circumferential strain were observed among patients with CA (LS: group 1, -20.6 6 2.5%; group 2, -11.6 6 4.1%; group 3, -9.0 +/- 3.1%; circumferential strain: group 1, -22.7 +/- 4.9%; group 2, -14.4 +/- 8.0%; group 3, -13.6 +/- 3.8%; P <.001 for both). Torsion did not vary between group 2 and group 1 (2.5 +/- 1.1-/cm vs 2.7 6 0.8-/cm, P = NS). In contrast, DefI was greater in group 2 than in group 1 (-1.8 6 0.8 degrees/% vs -1.0 6 0.3 degrees/%, P <.01). Torsion and DefI were lower in group 3 (1.2 6 0.7 degrees/cm and -1.1 6 0.6-/%, respectively, P <.001 for both) than in group 2. DefI was similar in patients with LV hypertrophy (-1.7 6 0.6 degrees/%, P = NS) and group 2.
Conclusions: In patients with CA, preservation of LVEF depends on greater ventricular wringing. DefI, a parameter that integrates the twist and the simultaneous longitudinal shortening of the left ventricle, is a more accurate indicator of the efficacy of this mechanism.
Filiaciones:
:
Department of Cardiology. Hospital Universitario Dr Peset. 46017 Valencia. Spain
:
Department of Cardiology. Hospital Universitario Dr Peset. 46017 Valencia. Spain
:
Department of Cardiology. Hospital Universitario Dr Peset. 46017 Valencia. Spain
:
Department of Cardiology. Hospital Universitario Dr Peset. 46017 Valencia. Spain
:
Department of Cardiology. Hospital Universitario Dr Peset. 46017 Valencia. Spain
Saad A:
Cardiodiagnosis Department. Medical Research. 1425 Buenos Aires, Argentina
:
Department of Cardiology. Hospital Universitario Dr Peset. 46017 Valencia. Spain
:
Department of Cardiology. Hospital Universitario Dr Peset. 46017 Valencia. Spain
Arbucci R:
Cardiodiagnosis Department. Medical Research. 1425 Buenos Aires, Argentina
Lowenstein J:
Cardiodiagnosis Department. Medical Research. 1425 Buenos Aires, Argentina
Bronze
|