Evaluating the Role of Multimodal Imaging in the Diagnosis of Cardiac Amyloidosis and Hypertrophic Cardiomyopathy

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology Pub Date : 2025-05-10 DOI:10.1111/anec.70086

Zi-xin Yang, Rong-hui Zheng, Cui-yan Wang, Hai-tao Yuan, Yong-le Sun, Mei Zhu

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Abstract

Objective

The objective of this study is to examine the evolving cardiac characteristics of patients with cardiac amyloidosis (CA) and hypertrophic cardiomyopathy (HCM) by integrating multimodal imaging techniques, including conventional echocardiography, strain echocardiography, and cardiac magnetic resonance imaging.

Methods

A retrospective study was conducted, comprising 38 patients with CA, 20 patients with HCM, and 16 healthy individuals in the control group. Statistical analyses were conducted to assess conventional and strain echocardiography parameters across these groups. Furthermore, cardiac magnetic resonance imaging data from 15 patients with CA and 15 patients with HCM were analyzed and compared, focusing on correlations between imaging parameters and myocardial amyloid load.

Results

Analysis of conventional and strain echocardiography revealed that left ventricular ejection fraction, E/e′, relative apical longitudinal sparing, and the ejection fraction-to-longitudinal strain ratio were strongly associated with the diagnosis of CA and served as key differentiators between the CA and HCM groups. The combination of these four parameters yielded optimal diagnostic efficiency, with an area under the curve of 0.916.

Conclusion

The integration of conventional and strain multiparametric echocardiography demonstrated superior diagnostic efficacy in differentiating CA from HCM. Furthermore, the analysis of cardiac magnetic resonance parameters indicated that an increase in cardiac amyloid load is associated with changes in cardiac indices, with parameters such as E/e′, basal longitudinal strain, global longitudinal strain, and ejection fraction-to-strain ratio effectively reflecting the extent of amyloid infiltration in the myocardium.

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评价多模态成像在心脏淀粉样变性和肥厚性心肌病诊断中的作用

本研究的目的是通过整合多模态成像技术，包括常规超声心动图、应变超声心动图和心脏磁共振成像，研究心脏淀粉样变性（CA）和肥厚性心肌病（HCM）患者心脏特征的演变。方法回顾性研究38例CA患者、20例HCM患者和16例健康人作为对照组。统计分析评估各组的常规和应变超声心动图参数。分析比较15例CA患者和15例HCM患者的心脏磁共振成像数据，重点分析成像参数与心肌淀粉样蛋白负荷的相关性。结果常规超声心动图和应变超声心动图分析显示，左心室射血分数、E/ E′、相对根尖纵向余量和射血分数/纵向应变比与CA的诊断密切相关，是区分CA组和HCM组的关键指标。4个参数联合使用诊断效率最佳，曲线下面积为0.916。结论常规超声心动图与应变多参数超声心动图结合对鉴别CA和HCM具有较好的诊断价值。此外，心脏磁共振参数分析表明，心脏淀粉样蛋白负荷的增加与心脏指标的变化有关，E/ E′、基底纵向应变、总纵向应变、射血分数-应变比等参数能有效反映淀粉样蛋白在心肌中的浸润程度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Noninvasive Electrocardiology 医学-心血管系统

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation. ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.