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Disease-specific differences of left ventricular rotational mechanics between cardiac amyloidosis and hypertrophic

Gaetano Nucifora1, Daniele Muser2, Giorgio Morocutti3

  • 1Cardiothoracic Department and gnucifora@cardionet.it.

American Journal of Physiology. Heart and Circulatory Physiology
|July 5, 2014
PubMed

Insights

Cardiac amyloidosis (CA) impairs left ventricular (LV) twist and untwisting, while hypertrophic cardiomyopathy (HCM) increases twist but preserves untwisting. Late gadolinium enhancement extent significantly impacts LV rotational mechanics in both conditions.

Area of Science:

  • Cardiology
  • Cardiac Imaging
  • Cardiomyopathy Research

Background:

  • Left ventricular (LV) twist (LVT) and untwisting (LVUT) are crucial indicators of LV function.
  • Understanding distinct alterations in LV rotational mechanics is vital for diagnosing and managing cardiac diseases.

Purpose of the Study:

  • To compare LV rotational mechanics between patients with cardiac amyloidosis (CA) and hypertrophic cardiomyopathy (HCM).
  • To identify factors influencing LV rotational mechanics in these patient groups.

Main Methods:

  • Cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE) imaging was utilized.
  • Feature-tracking analysis assessed peak LVT, time to peak LVT, peak LVUT rate, and time to peak LVUT rate.
  • Comparison between 20 CA patients, 20 HCM patients, and 20 controls.

Main Results:

  • CA patients showed impaired peak LVT and peak LVUT rate compared to controls.
  • HCM patients exhibited increased peak LVT but preserved peak LVUT rate.
  • Time to peak LVUT rate was prolonged in both CA and HCM patients versus controls.
  • Extent of LGE was a significant independent predictor for LVT, LVUT rate, and time to peak LVUT rate.

Conclusions:

  • Cardiac amyloidosis and hypertrophic cardiomyopathy demonstrate unique patterns of LV rotational mechanics.
  • The extent of late gadolinium enhancement is a key determinant of LV rotational dysfunction in CA and HCM.

Keywords:
cardiac amyloidosiscardiac magnetic resonancefeature-trackinghypertrophic cardiomyopathyrotational mechanics

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