PMID- 28784140 OWN - NLM STAT- MEDLINE DCOM- 20180501 LR - 20240117 IS - 1532-429X (Electronic) IS - 1097-6647 (Print) IS - 1097-6647 (Linking) VI - 19 IP - 1 DP - 2017 Aug 7 TI - Patterns of CMR measured longitudinal strain and its association with late gadolinium enhancement in patients with cardiac amyloidosis and its mimics. PG - 61 LID - 10.1186/s12968-017-0376-0 [doi] LID - 61 AB - BACKGROUND: Regional variability of longitudinal strain (LS) has been previously described with echocardiography in patients with cardiac amyloidosis (CA), however, the reason for this variability is not completely evident. We sought to describe regional patterns in LS using feature-tracking software applied to cardiovascular magnetic resonance (CMR) cine images in patients with CA, hypertrophic cardiomyopathy (HCM), and Anderson-Fabry's disease (AFD) and to relate these patterns to the distribution of late gadolinium enhancement (LGE). METHODS: Patients with CA (n = 45) were compared to LV mass indexed matched patients with HCM (n = 19) and AFD (n = 19). Peak systolic LS measurements were obtained using Velocity Vector Imaging (VVI) software on CMR cine images. A relative regional LS ratio (RRSR) was calculated as the ratio of the average of the apical segmental LS divided by the sum of the average basal and mid-ventricular segmental LS. LGE was quantified for the basal, mid, and apical segments using a threshold of 5SD above remote myocardium. A regional LGE ratio was calculated similar to RRSR. RESULTS: Patients with CA had significantly had worse global LS (-15.7 +/- 4.6%) than those with HCM (-18.0 +/- 4.6%, p = 0.046) and AFD (-21.9 +/- 5.1%, p < 0.001). The RRSR was higher in patients with CA (1.00 +/- 0.31) than in AFD (0.79 +/- 0.24; p = 0.018) but not HCM (0.84 +/- 0.32; p = 0.114). In CA, a regional difference in LGE burden was noted, with lower LGE in the apex (31.5 +/- 19.1%) compared to the mid (38.2 +/- 19.0%) and basal (53.7 +/- 22.7%; p < 0.001 for both) segments. The regional LGE ratio was not significantly different between patients with CA (0.33 +/- 0.15) and AFD (0.47 +/- 0.58; p = 0.14) but lower compared to those with HCM (0.72 +/- 0.43; p < 0.0001). LGE percentage showed a significant impact on LS (p < 0.0001), with a 0.9% decrease in absolute LS for every 10% increase in LGE percentage. CONCLUSION: The presence of marked "relative apical sparing" of LS along with a significant reduction in global LS seen in patients with CA on CMR cine analysis may provide an additional tool to differentiate CA from other cause of LVH. The concomitant presence of a base to apex gradient in quantitative LGE burden suggests that the regional strain gradient may be at least partially explained by the burden of amyloid deposition and fibrosis. FAU - Williams, Lynne K AU - Williams LK AD - Division of Cardiology, Peter Munk Cardiac Center, Ted Rogers Program in Cardiotoxicity Prevention, Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada. AD - Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, UK. FAU - Forero, Julian F AU - Forero JF AD - Department of Radiology and Diagnostic Imaging, Center for Excellence in Cardiovascualr Imaging, Fundacion Cardioinfantil Instituto de Cardiologia, Bogota, Colombia. AD - Department of Medical Imaging, University Health Network, Toronto, Canada. FAU - Popovic, Zoran B AU - Popovic ZB AD - Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Phelan, Dermot AU - Phelan D AD - Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Delgado, Diego AU - Delgado D AD - Division of Cardiology, Peter Munk Cardiac Center, Ted Rogers Program in Cardiotoxicity Prevention, Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada. FAU - Rakowski, Harry AU - Rakowski H AD - Division of Cardiology, Peter Munk Cardiac Center, Ted Rogers Program in Cardiotoxicity Prevention, Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada. FAU - Wintersperger, Bernd J AU - Wintersperger BJ AD - Department of Medical Imaging, University Health Network, Toronto, Canada. FAU - Thavendiranathan, Paaladinesh AU - Thavendiranathan P AUID- ORCID: 0000-0002-6497-1098 AD - Division of Cardiology, Peter Munk Cardiac Center, Ted Rogers Program in Cardiotoxicity Prevention, Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada. dinesh.thavendiranathan@uhn.ca. AD - Department of Medical Imaging, University Health Network, Toronto, Canada. dinesh.thavendiranathan@uhn.ca. LA - eng PT - Comparative Study PT - Journal Article DEP - 20170807 PL - England TA - J Cardiovasc Magn Reson JT - Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance JID - 9815616 RN - 0 (Contrast Media) RN - 0 (Organometallic Compounds) RN - 1BJ477IO2L (gadobutrol) SB - IM MH - Adult MH - Aged MH - Amyloidosis/*diagnostic imaging/pathology/physiopathology MH - Biomechanical Phenomena MH - Cardiomyopathies/*diagnostic imaging/pathology/physiopathology MH - Cardiomyopathy, Hypertrophic/diagnostic imaging/pathology/physiopathology MH - Contrast Media/*administration & dosage MH - Fabry Disease/*diagnostic imaging/pathology/physiopathology MH - Female MH - Fibrosis MH - Humans MH - Hypertrophy, Left Ventricular/*diagnostic imaging/pathology/physiopathology MH - Image Interpretation, Computer-Assisted MH - *Magnetic Resonance Imaging, Cine MH - Male MH - Middle Aged MH - Myocardium/pathology MH - Observer Variation MH - Organometallic Compounds/*administration & dosage MH - Predictive Value of Tests MH - Reproducibility of Results MH - Retrospective Studies MH - Software MH - Stress, Mechanical MH - *Ventricular Function, Left MH - Ventricular Remodeling PMC - PMC5545847 OTO - NOTNLM OT - Anderson Fabry's disease OT - Cardiac amyloidosis OT - Cardiovascular magnetic resonance imaging OT - Hypertrophic cardiomyopathy OT - Late gadolinium enhancement OT - Left ventricular hypertrophy OT - Myocardial strain COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Ethics approval was obtained from the Research Ethics Board of the University Health Network. CONSENT TO PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2017/08/09 06:00 MHDA- 2018/05/02 06:00 PMCR- 2017/08/07 CRDT- 2017/08/09 06:00 PHST- 2017/05/09 00:00 [received] PHST- 2017/07/18 00:00 [accepted] PHST- 2017/08/09 06:00 [entrez] PHST- 2017/08/09 06:00 [pubmed] PHST- 2018/05/02 06:00 [medline] PHST- 2017/08/07 00:00 [pmc-release] AID - S1097-6647(23)01095-5 [pii] AID - 376 [pii] AID - 10.1186/s12968-017-0376-0 [doi] PST - epublish SO - J Cardiovasc Magn Reson. 2017 Aug 7;19(1):61. doi: 10.1186/s12968-017-0376-0.