Speckle Tracking and Transthyretin Amyloid Cardiomyopathy

Rocha, Alexandre Marins; Ferreira, Suzane Garcia; Nacif, Marcelo Souto; Ribeiro, Mário Luiz; Freitas, Marcos R. G. de; Mesquita, Cláudio Tinoco

doi:10.5935/abc.20160191

Cited by 3 publications

(3 citation statements)

References 26 publications

(18 reference statements)

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“…Indeed, these measures may be better indicators of ATTR‐CM progression than LV wall thickness. LV GLS has also been shown to diagnose LV dysfunction in ATTR‐CM at the early stages of the disease 37 and to be diagnostically accurate when differentiating cardiac amyloidosis from other aetiologies 38 . Based on linear extrapolations of findings from the APOLLO trial and ATTR‐ACT, the panel recommended that a ≥1% increase in GLS was indicative of disease progression 13,36 .…”

Section: Resultsmentioning

confidence: 99%

Expert consensus on the monitoring of transthyretin amyloid cardiomyopathy

García‐Pavía

Bengel

Brito

et al. 2021

European J of Heart Fail

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Transthyretin amyloid cardiomyopathy (ATTR‐CM) is a life‐threatening condition with a heterogeneous clinical presentation. The recent availability of treatment for ATTR‐CM has stimulated increased awareness of the disease and patient identification. Stratification of patients with ATTR‐CM is critical for optimal management and treatment; however, monitoring disease progression is challenging and currently lacks best‐practice guidance. In this report, experts with experience in treating amyloidosis and ATTR‐CM developed consensus recommendations for monitoring the course of patients with ATTR‐CM and proposed meaningful thresholds and frequency for specific parameters. A set of 11 measurable features across three separate domains were evaluated: (i) clinical and functional endpoints, (ii) biomarkers and laboratory markers, and (iii) imaging and electrocardiographic parameters. Experts recommended that one marker from each of the three domains provides the minimum requirements for assessing disease progression. Assessment of cardiac disease status should be part of a multiparametric evaluation in which progression, stability or improvement of other involved systems in transthyretin amyloidosis should also be considered. Additional data from placebo arms of clinical trials and future studies assessing ATTR‐CM will help to elucidate, refine and define these and other measurements.

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Section: Resultsmentioning

confidence: 99%

Expert consensus on the monitoring of transthyretin amyloid cardiomyopathy

García‐Pavía

Bengel

Brito

et al. 2021

European J of Heart Fail

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“…The use of two-dimensional speckle tracking technique has been used to detect subclinical or initial changes of the disease, which may help in the treatment of the patients. 19 At initial stages, diagnosis of amyloidosis may be confounded with parietal hypertrophy, as in hypertrophic cardiomyopathy. However, characteristic findings are more frequently seen at more advanced stages of the disease and are observer-dependent.…”

Section: W H E N C a R D I A C A M Y L O I D O S I S I S S U S P E C mentioning

confidence: 99%

Cardiac Magnetic Resonance and amyloidosis: Review

Ribeiro

Oliveira

Neves

et al. 2019

International Journal of Cardiovascular Sciences

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Amyloidosis is a disease caused by extracellular deposition of insoluble protein fibrils, that results in changes in tissue architecture and consequently modification of the organ structure. Cardiac involvement is common in amyloidosis. Two major types of systemic amyloidosis affect the myocardium-immunoglobulin light chain and transthyretin amyloidosis-each leading to different prognosis. Early detection and diagnosis of cardiac amyloidosis are the main objectives in the assessment of the disease. New techniques of magnetic resonance imaging have minimized the need for biopsies for the diagnosis. Late gadolinium enhancement technique, and more recently T1 mapping, have allowed a simplified evaluation of amyloid deposits and extracellular volume. The aim of this review was to describe basic concepts and updates of the use of magnetic resonance imaging for the diagnosis amyloidosis and evaluation of its severity.

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“…Impairments in strain may occur earlier in the pathophysiology of CA [13] than overt structural 2-dimensional TTE changes [15, 20, 21] and clinical heart failure [22, 23]. Compared to patients with other forms of LVH, patients with amyloid cardiomyopathy have significantly reduced longitudinal and radial strain [24, 25] and demonstrate a characteristic pattern of diminished global longitudinal strain (LS) in the basal and mid left ventricular segments with preserved strain in the apex [26–28].…”

Section: Attr-ca Diagnostic and Management Goals In Elderly Adults: Rmentioning

confidence: 99%

Transthyretin Cardiac Amyloidosis in Older Adults: Optimizing Cardiac Imaging to the Corresponding Diagnostic and Management Goal

Castaño

Manson

Maurer

et al. 2017

Curr Cardiovasc Risk Rep

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Purpose of review Transthyretin cardiac amyloidosis is increasingly recognized as an important cause of heart failure in older adults. Many cardiac imaging modalities have evolved to evaluate transthyretin cardiac amyloidosis and include 2D echocardiography with tissue Doppler and speckle-strain imaging, nuclear scintigraphy, cardiac magnetic resonance imaging, and positron emission tomography. The purpose of this review is to highlight the optimal selection of advanced cardiac imaging techniques with corresponding diagnostic goals including raising suspicion, making an early diagnosis, and subtyping transthyretin cardiac amyloid, as well as management goals including assessment of ventricular impairment, prognosticating, and monitoring disease progression. Potential benefits of optimizing cardiac imaging in the elderly patient with transthyretin cardiac amyloidosis may include enhanced and earlier diagnosis and refined long-term management. Recent findings Advances in cardiac imaging techniques are changing diagnostic and management algorithms for transthyretin cardiac amyloidosis. Summary With a new era of novel therapeutics, enhanced recognition, and earlier diagnosis approaching, selecting the appropriate non-invasive cardiac imaging modality will be essential for optimal care in the elderly patient with transthyretin cardiac amyloidosis.

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Speckle Tracking and Transthyretin Amyloid Cardiomyopathy

Cited by 3 publications

References 26 publications

Expert consensus on the monitoring of transthyretin amyloid cardiomyopathy

Expert consensus on the monitoring of transthyretin amyloid cardiomyopathy

Cardiac Magnetic Resonance and amyloidosis: Review

Transthyretin Cardiac Amyloidosis in Older Adults: Optimizing Cardiac Imaging to the Corresponding Diagnostic and Management Goal

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