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Left atrial dysfunction in light-chain cardiac amyloidosis and hypertrophic cardiomyopathy - A comparative

Dóra Földeák1, Árpád Kormányos2, Péter Domsik2

  • 1Division of Haematology, 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.

Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology
|December 14, 2017
PubMed

Insights

Three-dimensional speckle-tracking echocardiography revealed distinct left atrial (LA) functional patterns in light-chain cardiac amyloidosis (AL-CA) versus hypertrophic cardiomyopathy (HCM). AL-CA showed reduced active atrial emptying and impaired LA strain compared to controls and HCM.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Imaging

Background:

  • Cardiac amyloidosis (CA) involves extracellular fibril deposition.
  • Hypertrophic cardiomyopathy (HCM) is characterized by myocyte hypertrophy and fibrosis.
  • Distinguishing AL-CA from HCM is crucial for patient management.

Purpose of the Study:

  • To compare left atrial (LA) volumetric and functional characteristics between light-chain cardiac amyloidosis (AL-CA) and hypertrophic cardiomyopathy (HCM).
  • To utilize three-dimensional speckle-tracking echocardiography (3D-STE) for detailed LA assessment.

Main Methods:

  • 16 AL-CA patients, 20 HCM patients, and 16 healthy controls underwent complete 2D Doppler echocardiography and 3D-STE.
  • Left atrial volumes and functional parameters were analyzed using 3D-STE.

Main Results:

  • Both AL-CA and HCM groups exhibited significantly increased LA volumes compared to controls.
  • AL-CA patients showed a significantly reduced active atrial emptying fraction and impaired global/segmental LA strain compared to controls.
  • Peak mean segmental longitudinal strain was significantly reduced in HCM patients compared to controls, with AL-CA showing further reductions in certain strain parameters.

Conclusions:

  • Three-dimensional speckle-tracking echocardiography reveals distinct patterns of LA functional characteristics in AL-CA and HCM.
  • These differences in LA function may aid in differentiating AL-CA from HCM.
Abstract

Keywords:
Amiloidose cardíacaAurícula esquerdaCardiac amyloidosisEchocardiographyEcocardiografiaFunctionFunçãoHypertrophic cardiomyopathyLeft atriumMiocardiopatia hipertróficaSpeckle-trackingThree-dimensionalTridimensional

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