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Updated: Sep 17, 2025

Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
06:34

Evaluation of Left Ventricular Structure and Function using 3D Echocardiography

Published on: October 28, 2020

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Utilization rates and determinants of PYP and CMR among patients with unexplained left ventricular hypertrophy on

Nathaniel A Fessehaie1, Hilary Bediako2, Michael J Kallan3

  • 1Department of Internal Medicine, Brigham and Women's Hospital, Boston, MA, United States of America.

International Journal of Cardiology
|June 27, 2025
PubMed

Insights

Cardiac amyloidosis (CA) diagnosis rates are low, with only 8.2% of eligible patients undergoing further testing. Advanced disease indicators like severe diastolic dysfunction and wall thickness increased the likelihood of follow-up testing for CA.

Area of Science:

  • Cardiology
  • Medical Diagnostics
  • Cardiac Imaging

Background:

  • Cardiac amyloidosis (CA) is an underdiagnosed cause of heart failure with significant morbidity and mortality.
  • Echocardiography is a key screening tool for CA, but subsequent diagnostic test utilization is not well understood.

Purpose of the Study:

  • To investigate the utilization rates of cardiac MRI (CMR) and PYP scans in patients with echocardiographic features suggestive of CA.
  • To identify clinical and echocardiographic factors associated with the use of CMR and PYP scans for CA diagnosis.

Main Methods:

  • Retrospective cohort study of patients (age ≥ 18) with moderate-to-severe left ventricular hypertrophy and diastolic dysfunction on echocardiography from December 2018 to September 2020.
  • Logistic regression models were used to determine factors associated with undergoing CMR or PYP scan.

Main Results:

  • Only 8.2% (83/1015) of eligible patients underwent further diagnostic testing for CA.
  • Factors associated with increased testing included older age (65+), Black race, HFrEF diagnosis, severe diastolic dysfunction, severe left ventricular wall thickness, and echocardiogram ordered by a cardiologist.

Conclusions:

  • Follow-up diagnostic testing for CA remains low even in patients with suggestive echocardiographic findings.
  • Characteristics indicative of more advanced disease were associated with higher rates of further testing, highlighting a need for earlier diagnostic strategies.
Abstract

Keywords:
Cardiac MRICardiac amyloidosisHeart failurePYP scan

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