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Myocardial Wringing and Rigid Rotation in Cardiac Amyloidosis

Vicente Mora1, Ildefonso Roldán1, Elena Romero1

  • 1Department of Cardiology, Hospital Universitario Dr Peset. Valencia, Spain.

CJC Open
|March 7, 2023
PubMed

Insights

Cardiac amyloidosis (CA) patients

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.
Abstract

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