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Volume 18 Supplement 1

19th Annual SCMR Scientific Sessions

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Determination of strain pattern in patients with cardiac amyloidosis secondary to Multiple myeloma: a feature tracking study


Cardiac MRI is frequently used in the diagnosis of cardiac amyloidosis. Feature tracking is a novel method of analyzing myocardial strain at the myocardial borders. We investigated myocardial deformation mechanics of both the right and left ventricles in patients with Multiple myeloma with suspected cardiac amyloidosis.


Comprehensive strain analysis was performed in 46 patients with multiple myeloma with suspected cardiac amyloidosis. MRI strain by feature tracking was measured using 2D cardiac performance analysis MR software (Tomtec, Germany). Global longitudinal strain (GLS) was obtained obtained from averaging longitudinal strains of apical 4-, 2- and 3-chamber views. Global circumferential strain (GCS) was obtained from averaging circumferential strains of the basal, mid and apical short axis views. Endocardial and epicardial contours were analyzed separately. Right ventricular GLS was derived from apical 4 chamber view, only endocardial contour was analyzed.


Table 1 depicts the MR characteristics of the cohort. Normal LV wall thickness was present in 47% with biopsy proven cardiac amyloidosis. GLS and strain rate were significantly reduced in the epicardial and endocardial layers. There was no statistically difference in radial and circumferential strain as well as right ventricular GL strain. Segmental GL strain analysis showed typical apical sparing pattern in the endocardium but not in the epicardium(base to apex gradient: -6.2 ± 2 vs. -1.2 ± 0.2; p < 0.001).


This feature tracking MRI analysis sheds light on strain mechanics in a cohort of early cardiac amyloidosis with a significant number of cases with normal LV wall thickness. Global longitudinal strain was affected earlier than radial and circumferential strain. Based on the pattern of apical sparing, amyloidosis affects epicardial strain earlier and without segmental variation compared to endocardial strain.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Bhatti, S., Vallurupalli, S., Ambach, S. et al. Determination of strain pattern in patients with cardiac amyloidosis secondary to Multiple myeloma: a feature tracking study. J Cardiovasc Magn Reson 18 (Suppl 1), P273 (2016).

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