Myocardial Wringing and Rigid Rotation in Cardiac Amyloidosis

Area of Science:

• Cardiology
• Cardiac Mechanics
• Medical Imaging

Background:

• Cardiac amyloidosis (CA) involves myofiber arrangement affecting heart motion.
• Understanding ventricular function in CA is crucial for patient management.

Purpose of the Study:

• To investigate the correlation between left ventricular (LV) wringing motion and ventricular function in CA patients.
• To assess LV wringing as a potential biomarker for assessing cardiac function in CA.

Main Methods:

• Utilized 2D speckle-tracking echocardiography in 50 CA patients with reduced global longitudinal strain (LS).
• Quantified LV wringing (twist/LS) and analyzed its relationship with LV ejection fraction (LVEF).
• Expressed LS as positive values; normal twist coded as positive, rigid rotation as negative.

Main Results:

• A significant positive correlation (r=0.75, P<0.0001) was found between LV wringing and LVEF.
• Rigid rotation (negative twist/wringing) observed in 66.6% of patients with LVEF ≤ 40%.
• LV wringing effectively discriminated LVEF (AUC 0.90), identifying LVEF < 50% with high sensitivity (85.7%) and specificity (89.7%).

Conclusions:

• LV wringing, integrating twist and longitudinal shortening, is a key parameter reflecting ventricular function in CA.
• LV wringing serves as a valuable diagnostic tool for assessing the degree of ventricular dysfunction in cardiac amyloidosis.