Influence of Ventricular Wringing on the Preservation of Left Ventricular Ejection Fraction in Cardiac Amyloidosis
Background: The purpose of this work was to determine the influence of myocardial wringing on ventricular function in patients with cardiac amyloidosis (CA). Methods: Fifteen healthy volunteers (group 1) and 34 patients with CA (17 with left ventricular ejection fractions [LVEFs] >= 53% [group 2]...
| Autores: | , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2021 |
| País: | España |
| Institución: | Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) |
| Repositorio: | r-FISABIO. Repositorio Institucional de Producción Científica |
| OAI Identifier: | oai:fisabio.fundanetsuite.com:p9289 |
| Acceso en línea: | https://fisabio.portalinvestigacion.com/publicaciones/9289 |
| Access Level: | acceso abierto |
| Palabra clave: | Cardiac amyloidosis Myocardial wringing Myocardial strain Ventricular torsion Ventricular function |
| Sumario: | Background: The purpose of this work was to determine the influence of myocardial wringing on ventricular function in patients with cardiac amyloidosis (CA). Methods: Fifteen healthy volunteers (group 1) and 34 patients with CA (17 with left ventricular ejection fractions [LVEFs] >= 53% [group 2] and 17 with LVEFs < 53% [group 3]) were evaluated using two-dimensional speckletracking echocardiography. A control group of mass-matched patients (n = 20) with left ventricular (LV) hypertrophy and LVEFs >= 53% was also included. Longitudinal strain (LS), circumferential strain, and LV twist and torsion were calculated. Deformation index (DefI), a new parameter of wringing, calculated as twist/LS, that takes into account actions that occur simultaneously during LV systole (i.e., longitudinal shortening and twist), was evaluated. Torsional and wringing parameters were calculated according to LVEF. Results: Lower global values of LS and circumferential strain were observed among patients with CA (LS: group 1, -20.6 6 2.5%; group 2, -11.6 6 4.1%; group 3, -9.0 +/- 3.1%; circumferential strain: group 1, -22.7 +/- 4.9%; group 2, -14.4 +/- 8.0%; group 3, -13.6 +/- 3.8%; P <.001 for both). Torsion did not vary between group 2 and group 1 (2.5 +/- 1.1-/cm vs 2.7 6 0.8-/cm, P = NS). In contrast, DefI was greater in group 2 than in group 1 (-1.8 6 0.8 degrees/% vs -1.0 6 0.3 degrees/%, P <.01). Torsion and DefI were lower in group 3 (1.2 6 0.7 degrees/cm and -1.1 6 0.6-/%, respectively, P <.001 for both) than in group 2. DefI was similar in patients with LV hypertrophy (-1.7 6 0.6 degrees/%, P = NS) and group 2. Conclusions: In patients with CA, preservation of LVEF depends on greater ventricular wringing. DefI, a parameter that integrates the twist and the simultaneous longitudinal shortening of the left ventricle, is a more accurate indicator of the efficacy of this mechanism. |
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