PMID- 26777222 OWN - NLM STAT- MEDLINE DCOM- 20161110 LR - 20170103 IS - 1876-7591 (Electronic) IS - 1876-7591 (Linking) VI - 9 IP - 2 DP - 2016 Feb TI - Causes and Consequences of Longitudinal LV Dysfunction Assessed by 2D Strain Echocardiography in Cardiac Amyloidosis. PG - 126-38 LID - S1936-878X(15)00860-8 [pii] LID - 10.1016/j.jcmg.2015.05.014 [doi] AB - OBJECTIVES: The aim of this study was to compare left ventricular longitudinal strain (LS) evaluated by 2-dimensional echocardiography with cardiac magnetic resonance (CMR) in cardiac amyloidosis (CA), establish correlations between histological and imaging findings, and assess the prognostic usefulness of LS measurement and CMR. BACKGROUND: CA is a condition with a poor prognosis due chiefly to 3 forms of amyloidosis: light-chain amyloidosis (AL), hereditary transthyretin (M-TTR), and wild-type transthyretin (WT-TTR). Two-dimensional echocardiography measurement of LS has been reported to detect early left ventricular systolic dysfunction. The pathophysiological underpinnings, regional distribution, and prognostic significance of LS in CA are unclear. METHODS: All patients underwent echocardiography, and 53 underwent CMR. The native hearts of the 3 patients who received heart transplants were subjected to histological examination. For each of the 17 left ventricular segments in the American Heart Association model, we evaluated LS, late gadolinium enhancement (LGE) by CMR, and cardiac amyloid deposition. Univariate and multivariate analyses were performed at 6 months to identify variables associated with major adverse cardiac events (MACE). RESULTS: We studied 79 patients with CA; 26 had AL, 36 M-TTR, and 17 WT-TTR. Mean LS was -10 +/- 4%. Both LS and amyloid deposits showed a basal-to-apical gradient. The mean LS and number of segments with LGE were similar across the 3 CA types. LS correlated with LGE and amyloid burden (r = 0.72). LGE was seen in the 6 basal segments in all WT-TTR patients. During the median follow-up of 11 months (range 4 to 17 months), 36 (46%) patients experienced MACE. Independent predictors of MACE were apical LS (cutoff, -14.5%), N-terminal pro-B-type natriuretic peptide (cutoff, 4,000 ng/l), and New York Heart Association functional class III to IV heart failure. CONCLUSIONS: Basal-to-apical LS abnormalities are similar across CA types and reflect the amyloid burden. Apical LS independently predicts MACE. CI - Copyright (c) 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Ternacle, Julien AU - Ternacle J AD - UPEC, Creteil, France; Mondor Amyloidosis Network, Creteil, France; Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Creteil, France; INSERM U955, GRC Amyloid Research Institute, Creteil, France; DHU ATVB, Creteil, France; INSERM Clinical Investigation Center 006, Creteil, France. FAU - Bodez, Diane AU - Bodez D AD - UPEC, Creteil, France; Mondor Amyloidosis Network, Creteil, France; Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Creteil, France; INSERM U955, GRC Amyloid Research Institute, Creteil, France; DHU ATVB, Creteil, France; INSERM Clinical Investigation Center 006, Creteil, France. FAU - Guellich, Aziz AU - Guellich A AD - UPEC, Creteil, France; Mondor Amyloidosis Network, Creteil, France; Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Creteil, France; INSERM U955, GRC Amyloid Research Institute, Creteil, France; DHU ATVB, Creteil, France; INSERM Clinical Investigation Center 006, Creteil, France. FAU - Audureau, Etienne AU - Audureau E AD - Mondor Amyloidosis Network, Creteil, France; Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Creteil, France; Department of Public Health, AP-HP, Henri-Mondor Teaching Hospital and Clinical Epidemiology and Aging EA 4393, Creteil, France. FAU - Rappeneau, Stephane AU - Rappeneau S AD - UPEC, Creteil, France; Mondor Amyloidosis Network, Creteil, France; Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Creteil, France; INSERM U955, GRC Amyloid Research Institute, Creteil, France; DHU ATVB, Creteil, France; INSERM Clinical Investigation Center 006, Creteil, France. FAU - Lim, Pascal AU - Lim P AD - UPEC, Creteil, France; Mondor Amyloidosis Network, Creteil, France; Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Creteil, France; DHU ATVB, Creteil, France; INSERM Clinical Investigation Center 006, Creteil, France. FAU - Radu, Costin AU - Radu C AD - UPEC, Creteil, France; Mondor Amyloidosis Network, Creteil, France; DHU ATVB, Creteil, France; INSERM Clinical Investigation Center 006, Creteil, France; Department of Public Health, AP-HP, Henri-Mondor Teaching Hospital and Clinical Epidemiology and Aging EA 4393, Creteil, France. FAU - Guendouz, Soulef AU - Guendouz S AD - UPEC, Creteil, France; Mondor Amyloidosis Network, Creteil, France; Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Creteil, France; INSERM U955, GRC Amyloid Research Institute, Creteil, France; DHU ATVB, Creteil, France; INSERM Clinical Investigation Center 006, Creteil, France. FAU - Couetil, Jean-Paul AU - Couetil JP AD - Mondor Amyloidosis Network, Creteil, France; DHU ATVB, Creteil, France; Department of Cardiovascular Surgery, AP-HP, Henri-Mondor Teaching Hospital, Creteil, France. FAU - Benhaiem, Nicole AU - Benhaiem N AD - Department of Pathology, AP-HP, Henri-Mondor Teaching Hospital, Creteil, France. FAU - Hittinger, Luc AU - Hittinger L AD - UPEC, Creteil, France; Mondor Amyloidosis Network, Creteil, France; Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Creteil, France; INSERM U955, GRC Amyloid Research Institute, Creteil, France; DHU ATVB, Creteil, France; INSERM Clinical Investigation Center 006, Creteil, France. FAU - Dubois-Rande, Jean-Luc AU - Dubois-Rande JL AD - UPEC, Creteil, France; Mondor Amyloidosis Network, Creteil, France; Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Creteil, France; INSERM U955, GRC Amyloid Research Institute, Creteil, France; DHU ATVB, Creteil, France; INSERM Clinical Investigation Center 006, Creteil, France. FAU - Plante-Bordeneuve, Violaine AU - Plante-Bordeneuve V AD - UPEC, Creteil, France; Mondor Amyloidosis Network, Creteil, France; INSERM Clinical Investigation Center 006, Creteil, France; Department of Neurology, AP-HP, Henri-Mondor Teaching Hospital, Creteil, France. FAU - Mohty, Dania AU - Mohty D AD - Department of Cardiology, Dupuytren Hospital, CHU Limoges, Pole Coeur-Poumon-Rein, Limoges, France. FAU - Deux, Jean-Francois AU - Deux JF AD - UPEC, Creteil, France; Mondor Amyloidosis Network, Creteil, France; Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Creteil, France; INSERM Clinical Investigation Center 006, Creteil, France; Department of Radiology, AP-HP, Henri-Mondor Teaching Hospital, Creteil, France. FAU - Damy, Thibaud AU - Damy T AD - UPEC, Creteil, France; Mondor Amyloidosis Network, Creteil, France; Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Creteil, France; INSERM U955, GRC Amyloid Research Institute, Creteil, France; DHU ATVB, Creteil, France; INSERM Clinical Investigation Center 006, Creteil, France. Electronic address: thibaud.damy@hmn.aphp.fr. LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20160106 PL - United States TA - JACC Cardiovasc Imaging JT - JACC. Cardiovascular imaging JID - 101467978 SB - IM CIN - JACC Cardiovasc Imaging. 2016 Feb;9(2):139-41. PMID: 26777215 MH - Aged MH - Aged, 80 and over MH - Amyloidosis/*complications/diagnosis MH - Biomechanical Phenomena MH - Biopsy MH - Cardiomyopathies/*complications/diagnosis MH - Female MH - Humans MH - *Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - Multimodal Imaging/*methods MH - Myocardium/*pathology MH - Predictive Value of Tests MH - Prognosis MH - Prospective Studies MH - Risk Factors MH - Stress, Mechanical MH - Time Factors MH - Ventricular Dysfunction, Left/*diagnostic imaging/etiology/physiopathology MH - *Ventricular Function, Left OTO - NOTNLM OT - amyloid OT - heart failure OT - prognosis OT - speckle tracking EDAT- 2016/01/19 06:00 MHDA- 2016/11/12 06:00 CRDT- 2016/01/19 06:00 PHST- 2015/02/10 00:00 [received] PHST- 2015/04/23 00:00 [revised] PHST- 2015/05/14 00:00 [accepted] PHST- 2016/01/19 06:00 [entrez] PHST- 2016/01/19 06:00 [pubmed] PHST- 2016/11/12 06:00 [medline] AID - S1936-878X(15)00860-8 [pii] AID - 10.1016/j.jcmg.2015.05.014 [doi] PST - ppublish SO - JACC Cardiovasc Imaging. 2016 Feb;9(2):126-38. doi: 10.1016/j.jcmg.2015.05.014. Epub 2016 Jan 6.