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Archives of cardiovascular diseases
Volume 106, n° 4
page 265 (avril 2013)
Doi : 10.1016/j.acvd.2013.03.054

Left ventricular function assessment by 3D-speckle tracking echocardiography in patients with light chains amyloidosis

S. Pradel a, D. Mohty a, T. Damy b, V. Aboyans a, D. Lavergne a, A. Jaccard a
a CHU Dupuytren, Limoges, France 
b CHU Henri-Mondor, Créteil, France 

Background and objective .– Transthoracic echocardiography (TTE) is usually performed for patients with light chains amyloidosis (AL) when cardiac involvement is suspected. The latter is typically characterized by left ventricular (LV) diastolic dysfunction. However, the LV systolic ejection fraction (LVEF) is usually preserved.

Whether, the different components of the LV systolic contraction are altered in AL, is unknown.

The aim of this preliminary study was to assess the main components of the global LV systolic function, (longitudinal, circumferential, radial, area tracking and twist) using a 3D wall motion tracking imaging, a recent technique coupling a 3D volumetric acquisition with a wall motion tracking imaging in a serie of consecutive healthy controls and in patients with AL according to the Mayo Clinic staging.

Methods and results .– Twenty-nine consecutive subjects (six controls and 23 with AL and different degree of cardiac severity) were analysed. Classical 2DTTE parameters were obtained along with the 3D LV parameters: mean age was 66±10years, 55% were male. Compared to controls and to those with minimal/moderate (stage I/II) cardiac involvement, those with severe cardiac involvement (stage III) had significantly lower 3DLVEF, 3DLV global: longitudinal, circumferential, radial strain and lower area tracking (Table 1) (all P <0.05). However, the 3D LV rotation and twist function were not different between the three groups. Traditional 2DTTE showed significant differences in diastolic function in stage III AL compared to those in stage I/II and controls; however, it was not able to detect significant differences in LV volumes and LVEF.

Conclusion .– Our preliminary study is the first to assess all components of LV contraction using simultaneous 3D full volume acquisition and wall motion tracking imaging in AL patients. Larger studies are needed to confirm these results and to assess their impact on outcome and management of AL patients.

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© 2013  Published by Elsevier Masson SAS.
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