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Determination of strain pattern in patients with cardiac amyloidosis secondary to Multiple myeloma: a feature tracking study
© Bhatti et al. 2016
- Published: 27 January 2016
- Multiple Myeloma
- Circumferential Strain
- Global Longitudinal Strain
- Cardiac Amyloidosis
- Feature Tracking
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).
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