Apical sparing pattern during exercise echocardiography in patients with cardiac amyloidosis

Abstract Funding Acknowledgements Type of funding sources: None. Background Apical sparing (AS) is an useful marker cardiac amyloidosis (CA). However, this pattern can also be found in other conditions that lead to left ventricular hypertrophy (LVI), like hypertension (HT) or hypertropic cardiomyopathy (HCM). We aimed assess the AS at rest and exercise patients with CA LVI-no CA. hypothesize may have preserved on contrary CA, therefore increasing specificity sign. Methods Teen confirmed 31 (17 HCM, 14 HT plus LVI), 6 normal subjects were studied by treadmill echocardiography, assessment global longitudinal strain (LS) peak (Pk-Ex). should age >60 y-o, no data coronary artery disease, absence ischemia, LVEF>55%. A relative apical LS 1.0, equation: average LS/(average basal + mid-LS)) was used for considering AS. Results Patients older (81±5 yo; 70±8 74±4 p = 0.001), had lower LVEF (51±14; vs 66±9 67±10 group; higher E/e´values (21±7, 18±10 9±1 0.03), but achieved similar workload metabolic equivalents (METs) during (6.3±2.9 METs 7.1±2.2 7.6±2.7 group). Pk-Ex 0.7±0.2 0.6±0.2 patients; 0.7±0.5 0.7±0.3 subjects; 1.6±0.8 1.2±0.4 (<0.001 between groups either Pk-Ex). The highest area under ROC curve diagnosing corresponded (0.86; 95% CI 0.72–0.99, followed (0.81; CI=0.63–0.99, 0.003), (0.80; CI=0.62–0.98, 0.004) (0.75; CI=0.54–0.96, 0.02). Among 5/10 Pk-ex, none non-CA subjects, given positive predictive value 100%. (figure) In conclusion, adds information diagnosis our sample, persists pathognomonic amyloidosis.