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Amyloid
The Journal of Protein Folding Disorders
Volume 16, 2009 - Issue 2
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Original Article

Tissue Doppler and strain imaging: a new tool for early detection of cardiac amyloidosis

, , , , , , , , , , , & show all
Pages 63-70 | Published online: 13 Aug 2009
 

Abstract

Using traditional echocardiography, the diagnosis of cardiac amyloidosis (CA) is often only possible in advanced stage when recommended therapies may have adverse effects. The aim of our study was to evaluate whether additional information can be derived from Tissue and strain Doppler imaging (TDI and SDI). Forty patients with systemic amyloidosis and 24 healthy subjects underwent traditional, tissue and strain Doppler echocardiography. Patients were classified having CA if mean wall thickness (mT), was half of the sum septum and posterior wall thickness, was ≥12 mm. The following parameters were evaluated: peak early diastolic velocity (Em) as index of ventricular relaxation, mitral E-wave to Em ratio (E/Em) as index of left ventricular (LV) filling pressure and mean LV strain peak curves (mSt) as global long-axis contraction index. In non cardiac amyloidosis (NCA), both Em and mSt were lower than in age matched controls (p < 0.01, p < 0.05, respectively) and higher than in CA (p < 0.01 and p < 0.01, respectively). Both Em and mSt were related to mT (p < 0.001). A significant (p < 0.01) nonlinear relation was observed between plasma terminal of pro B-natriuretic peptide and mT, Em, E/Em and mSt. TDI and SDI are able to detect amyloid myocardial involvement in such an early stage that cannot be evidenced by using traditional echocardiography.

Abbreviations
CA=

cardiac amyloidosis

NCA=

non cardiac amyloidosis

SDI=

strain Doppler imaging

TDI=

tissue doppler imaging

Abbreviations
CA=

cardiac amyloidosis

NCA=

non cardiac amyloidosis

SDI=

strain Doppler imaging

TDI=

tissue doppler imaging

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