Utility of advanced echocardiographic deformation measures to delineate cause of pathological left ventricular hypertrophy: value of a multiparametric approach

Abstract Background Early diagnosis of cardiac amyloidosis (CA) is warranted to initiate specific treatment and improve outcomes. Conventional echocardiography unable reliably differentiate CA from other causes increased left ventricular (LV) wall thickness. Purpose To demonstrate the value a multiparametric approach utilising both standard advanced echocardiographic measures distinguish pathological LV Results Patients with HCM had highest septal thickness, maximum septum/posterior (Sep/PW) thickness ratio outflow tract (LVOT) gradient lowest PW (p<0.0001) among all groups. global longitudinal strain (GLS), tissue Doppler-derived myocardial systolic diastolic velocities ejection fraction (EF) (p<0.0001). EF (EFSR=LVEF/GLS) (apex/base) were (largest number) in patients Multivariate linear regression identified 5 independent predictors (PW Sep/PW ratio, LVOT gradient, GLS) that discriminated A equation (using multivariate regression) {CA prediction = (0.230*LS apex/base) − (0.002*LVOT gradient) [0.068*(Sep/PW ratio)] + (0.007*PW thickness) (0.022*GLS) 0.189; r=0.667)} was derived which allowed reliable distinction sensitivity 92.3% specificity 91.2% at optimal cut-off. Conclusion GLS are CA. We developed discrimination Future studies involving larger cohorts required validate these findings. Funding Acknowledgement Type funding sources: None.