The role of three-dimensional speckle tracking imaging in the diagnosis of immunoglobulin light-chain cardiac amyloidosis with normal left ventricular ejection fraction

Q4 Medicine

中华超声影像学杂志 Pub Date : 2020-03-25 DOI:10.3760/CMA.J.CN131148-20190813-00483

C. Lei, L. Zuo, Yan Wang, Xiaoli Zhu, M. Zhou, Qian Yang, Hanxi Xu, Liwen Liu

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引用次数: 1

Abstract

Objective To explore the value of three-dimensional speckle tracking imaging (3D-STI) in the diagnosis of immunoglobulin light-chain cardiac amyloidosis(AL-CA) patients with normal left ventricular ejection fraction (LVEF). Methods A total of 92 consecutive patients diagnosed with systemic immunoglobulin light chain amyloidosis(sAL) and with normal LVEF from October 2014 to January 2018 in Xijing Hospital were enrolled.Based on the diagnostic criteria of cardiac involvement, the patients were divided into AL-CA group (52 cases) and immunoglobulin light chain amyloidosis (AL) group (40 cases). The clinical data and serological markers of the patients were collected, the conventional echocardiography and full-volume three dimensional dynamic images were acquired, left ventricular global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), and global area strain (GAS) were analyzed using off-line TomTec software. The differences between the two groups were compared. Results Compared with the AL group, the NT-proBNP of AL-CA group was significantly higher (P 0.05). Compared with the AL group, the maximal left ventricular wall thickness, left ventricular mass index, left atrial volume index, and E/e′ in the AL-CA group were significantly increased (all P 0.05). Compared with the AL group, GLS, GAS, and GRS were significantly lower in AL-CA group (all P 0.05). The ROC curve analysis showed that the cut-off values discriminating cardiac involvement were 16.09% for GLS, 36.54% for GAS and 31.90% for GRS. Conclusions 3D-STI measurements of left ventricular myocardial mechanics could detect cardiac involvement in patients with sAL amyloidosis, and provides a new method for diagnosis of AL-CA. Key words: Echocardiography; Three-dimensional speckle tracking imaging; Immunoglobulin light-chain cardiac amyloidosis; Strain

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三维散斑追踪成像在诊断左心室射血分数正常的免疫球蛋白轻链心脏淀粉样变性中的作用

目的探讨三维散斑跟踪成像（3D-STI）对左心室射血分数（LVEF）正常的免疫球蛋白轻链心脏淀粉样变性（AL-CA）患者的诊断价值。方法对2014年10月至2018年1月在西京医院连续诊断为系统性免疫球蛋白轻链淀粉样变性（sAL）且LVEF正常的92例患者进行研究。根据心脏受累的诊断标准，将患者分为AL-CA组（52例）和免疫球蛋白轻链淀粉样变性（AL）组（40例）。收集患者的临床数据和血清学标志物，获取常规超声心动图和全容积三维动态图像，使用离线TomTec软件分析左心室整体纵向应变（GLS）、整体径向应变（GRS）、总体周向应变（GCS）和整体面积应变（GAS）。比较两组之间的差异。结果AL-CA组NT-proBNP明显高于AL组（P＜0.05）。与AL组相比，AL-CA组的最大左心室壁厚、左心室质量指数、左心房容积指数和E/E′均显著增加（均P＜0.01），ROC曲线分析显示，GLS、GAS和GRS判断心脏受累的临界值分别为16.09%、36.54%和31.90%。结论左心室心肌力学3D-STI测量可检测sAL淀粉样变性患者的心脏受累，为诊断AL-CA提供了一种新的方法。关键词：超声心动图；三维散斑跟踪成像；免疫球蛋白轻链心脏淀粉样变性；应变

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来源期刊

中华超声影像学杂志 Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

0.80

自引率

0.00%

发文量

9126

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