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Biventricular Strain Imaging with Cardiac MRI in Genotyped and Histology Validated Amyloid Cardiomyopathy

1
Department of Medicine, Division of Cardiology, Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY 14203, USA
2
Department of Radiology, Division of Nuclear Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
3
Department of Pathology and Laboratory Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA
4
Department of Medicine, Division of Cardiology, Yale School of Medicine, New Haven, CT 06510, USA
*
Author to whom correspondence should be addressed.
Cardiogenetics 2021, 11(3), 98-110; https://doi.org/10.3390/cardiogenetics11030011
Received: 8 February 2021 / Revised: 27 April 2021 / Accepted: 23 June 2021 / Published: 30 June 2021
(This article belongs to the Section Cardiovascular Genetics in Clinical Practice)
Cardiac amyloidosis (CA) is a common and potentially fatal infiltrative cardiomyopathy. Contrast-enhanced cardiac MRI (CMR) is used as a diagnostic tool. However, utility of CMR for the comprehensive analysis of biventricular strains and strain rates is not reported as extensively as echocardiography. In addition, RV strain analysis using CMR has not been described previously. Objectives: We sought to study the global and regional indices of biventricular strain and strain rates in endomyocardial biopsy (EMB)-proven, genotyped cases of CA. Methods: A database of 80 EMBs was curated from 2012 to 2019 based on histology. A total of 19 EMBs positive for CA were subjected to further tissue-characterization with histology, and compared with four normal biopsy specimens. Samples were genotyped for ATTR- or AL-subtypes. Five patients, with both echocardiography and contrast-enhanced CMR performed 72-h apart, were subjected to comprehensive analysis of biventricular strain and strain-rates. Results: Histology confirmed that the selected samples were indeed positive for cardiac amyloid. Echocardiography showed reduced global and regional left-ventricular (LV) longitudinal strain indices. CMR with tissue-characterization of LV showed global reductions in circumferential, radial and longitudinal strains and strain-rates, following a general trend with the echocardiographic findings. The basal right-ventricular (RV) segments had reduced circumferential strains with no changes in longitudinal strain. Conclusions: In addition to providing a clinical diagnosis of CA based on contrast clearance-dynamics, CMR can be a potent tool for accurate functional assessment of global and regional changes in strain and strain-rates involving both LV and RV. Further studies are warranted to validate and curate the strain imaging capacity of CMR in CA. View Full-Text
Keywords: amyloidosis; cardiac MRI; endomyocardial biopsy; strain imaging amyloidosis; cardiac MRI; endomyocardial biopsy; strain imaging
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MDPI and ACS Style

Reddy, A.; Singh, V.; Karthikeyan, B.; Jiang, L.; Kristo, S.; Kattel, S.; Amuthan, R.; Pokharel, S.; Sharma, U.C. Biventricular Strain Imaging with Cardiac MRI in Genotyped and Histology Validated Amyloid Cardiomyopathy. Cardiogenetics 2021, 11, 98-110. https://doi.org/10.3390/cardiogenetics11030011

AMA Style

Reddy A, Singh V, Karthikeyan B, Jiang L, Kristo S, Kattel S, Amuthan R, Pokharel S, Sharma UC. Biventricular Strain Imaging with Cardiac MRI in Genotyped and Histology Validated Amyloid Cardiomyopathy. Cardiogenetics. 2021; 11(3):98-110. https://doi.org/10.3390/cardiogenetics11030011

Chicago/Turabian Style

Reddy, Abhinay, Vasvi Singh, Badri Karthikeyan, Leyi Jiang, Silva Kristo, Sharma Kattel, Ram Amuthan, Saraswati Pokharel, and Umesh C. Sharma 2021. "Biventricular Strain Imaging with Cardiac MRI in Genotyped and Histology Validated Amyloid Cardiomyopathy" Cardiogenetics 11, no. 3: 98-110. https://doi.org/10.3390/cardiogenetics11030011

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