Apical Sparing in Routine Echocardiography: Occurrence and Clinical Significance
Apical sparing is an echocardiographic pattern where myocardial strain is preserved at the apex compared to the basal segments. In a normal heart, longitudinal strain shows a gradient with lower values at the base and higher at the apex. This gradient becomes more pronounced in pathological states,...
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MDPI AG
2024-08-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/11/9/262 |
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| author | Marina Leitman Vladimir Tyomkin |
| author_facet | Marina Leitman Vladimir Tyomkin |
| author_sort | Marina Leitman |
| collection | DOAJ |
| description | Apical sparing is an echocardiographic pattern where myocardial strain is preserved at the apex compared to the basal segments. In a normal heart, longitudinal strain shows a gradient with lower values at the base and higher at the apex. This gradient becomes more pronounced in pathological states, such as cardiac amyloidosis, resulting in a relative apical sparing effect. This study explores cardiac conditions associated with apical sparing and the underlying mechanisms. We reviewed echocardiography examinations reporting apical sparing from 2021 to 2024 in our hospital database. Relevant echo exams and clinical data were retrieved and analyzed. Apical sparing was identified in 74 patients. Cardiac amyloidosis was diagnosed in 12 patients (16.2%). Other cardiac pathologies potentially contributing to apical sparing included hypertrophic cardiomyopathy, left ventricular hypertrophy due to hypertension, end-stage renal disease, coronary artery disease (involving the right coronary artery and left circumflex), reversed Takotsubo syndrome, and chemotherapy-induced cardiomyopathy. The clinical context of echocardiography was crucial in guiding the diagnostic work-up. Apical sparing is a nonspecific echocardiographic finding associated with various cardiac conditions. Its diagnostic value depends heavily on the clinical context. Understanding the broader clinical picture is essential for accurate interpretation and diagnosis. |
| format | Article |
| id | doaj-art-2bb6a00980a648d5a750eb2e8e4efe52 |
| institution | OA Journals |
| issn | 2308-3425 |
| language | English |
| publishDate | 2024-08-01 |
| publisher | MDPI AG |
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| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-2bb6a00980a648d5a750eb2e8e4efe522025-08-20T01:55:34ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252024-08-0111926210.3390/jcdd11090262Apical Sparing in Routine Echocardiography: Occurrence and Clinical SignificanceMarina Leitman0Vladimir Tyomkin1Department of Cardiology, Shamir Medical Center, Zerifin 70300, IsraelDepartment of Cardiology, Shamir Medical Center, Zerifin 70300, IsraelApical sparing is an echocardiographic pattern where myocardial strain is preserved at the apex compared to the basal segments. In a normal heart, longitudinal strain shows a gradient with lower values at the base and higher at the apex. This gradient becomes more pronounced in pathological states, such as cardiac amyloidosis, resulting in a relative apical sparing effect. This study explores cardiac conditions associated with apical sparing and the underlying mechanisms. We reviewed echocardiography examinations reporting apical sparing from 2021 to 2024 in our hospital database. Relevant echo exams and clinical data were retrieved and analyzed. Apical sparing was identified in 74 patients. Cardiac amyloidosis was diagnosed in 12 patients (16.2%). Other cardiac pathologies potentially contributing to apical sparing included hypertrophic cardiomyopathy, left ventricular hypertrophy due to hypertension, end-stage renal disease, coronary artery disease (involving the right coronary artery and left circumflex), reversed Takotsubo syndrome, and chemotherapy-induced cardiomyopathy. The clinical context of echocardiography was crucial in guiding the diagnostic work-up. Apical sparing is a nonspecific echocardiographic finding associated with various cardiac conditions. Its diagnostic value depends heavily on the clinical context. Understanding the broader clinical picture is essential for accurate interpretation and diagnosis.https://www.mdpi.com/2308-3425/11/9/262apical sparingamyloidosishypertrophic cardiomyopathyaortic stenosisend-stage renal diseasehypertension |
| spellingShingle | Marina Leitman Vladimir Tyomkin Apical Sparing in Routine Echocardiography: Occurrence and Clinical Significance Journal of Cardiovascular Development and Disease apical sparing amyloidosis hypertrophic cardiomyopathy aortic stenosis end-stage renal disease hypertension |
| title | Apical Sparing in Routine Echocardiography: Occurrence and Clinical Significance |
| title_full | Apical Sparing in Routine Echocardiography: Occurrence and Clinical Significance |
| title_fullStr | Apical Sparing in Routine Echocardiography: Occurrence and Clinical Significance |
| title_full_unstemmed | Apical Sparing in Routine Echocardiography: Occurrence and Clinical Significance |
| title_short | Apical Sparing in Routine Echocardiography: Occurrence and Clinical Significance |
| title_sort | apical sparing in routine echocardiography occurrence and clinical significance |
| topic | apical sparing amyloidosis hypertrophic cardiomyopathy aortic stenosis end-stage renal disease hypertension |
| url | https://www.mdpi.com/2308-3425/11/9/262 |
| work_keys_str_mv | AT marinaleitman apicalsparinginroutineechocardiographyoccurrenceandclinicalsignificance AT vladimirtyomkin apicalsparinginroutineechocardiographyoccurrenceandclinicalsignificance |