Echocardiographic myocardial stiffness for the diagnosis and tissue characterization of cardiac amyloidosis

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main source(s): Swiss National Science Foundation Philips Healthcare. Introduction Intrinsic cardiac elastography in echocardiography estimates myocardial stiffness by measuring the propagation stretch generated atrial contraction. The aims present study were (A) to assess its value differentiating amyloidosis (CA) from hypertrophic cardiomyopathy (HCM) and healthy volunteers (controls), B) correlate it with an established marker amyloid burden fibrosis. Methods This prospective evaluated 52 participants CA (n=27), HCM (n=9) controls (n=16) ultra-high-frame rate (above 250 frames/sec) ultrasound imaging using diverging beam mode. slope isovelocity wave front was measured as intrinsic velocity (iVP, m/s). Additionally, underwent comprehensive transthoracic including quantification global longitudinal strain (GLS) speckle-tracking imaging. relative apical sparing (RELAPS) ratio calculated average GLS segments / midventricular basal segments. Extracellular volume (ECV) native post-contrast T1 mapping magnetic resonance (CMR) quantified 12 4 HCM. Results iVP significantly higher (i.e., 2.6 m/s [1.7–3.8]) than (1.2 [1.0–1.8], p = 0.001) (1.4 [1.3–1.5], 0.004) but did not differ between (p 0.928; Panel A). diagnostic accuracy identify 82% similar RELAPS 84%). > 2.0 has a sensitivity, specificity, positive predictive negative 59%, 100%, 69% diagnose among participants. There strong correlation ECV (rho=0.747, 0.001; B). In contrast, correlated weakly moderately (rho=0.514, 0.001), (rho=0.433, 0.008), E/e’ (rho=0.413, 0.014) NT-proBNP (rho=0.476, 0.006). Conclusions Echocardiographic is highly specific provides unique insights into tissue composition.