Strain echocardiography predictors in patients with concomitant cardiac amyloidosis and aortic stenosis: a cross-sectional study
Abstract Background Concomitant cardiac amyloidosis (CA) and aortic stenosis (AS) may be mistaken for isolated AS, potentially impacting the treatment strategy and patient’s prognosis. Therefore, it is crucial to distinguish between these conditions, as failure to promptly diagnose CA may lead to co...
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BMC
2024-12-01
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| Online Access: | https://doi.org/10.1186/s12872-024-04415-8 |
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| author | Samira Jafarisis Shahab Masoumi Naser Khezerlouy-Aghdam Kia Seyed Toutounchi Amirreza Jabbaripour Sarmadian Sina Hamzehzadeh Akram Shariati Razieh Parizad Venus Shahabi Rabori |
| author_facet | Samira Jafarisis Shahab Masoumi Naser Khezerlouy-Aghdam Kia Seyed Toutounchi Amirreza Jabbaripour Sarmadian Sina Hamzehzadeh Akram Shariati Razieh Parizad Venus Shahabi Rabori |
| author_sort | Samira Jafarisis |
| collection | DOAJ |
| description | Abstract Background Concomitant cardiac amyloidosis (CA) and aortic stenosis (AS) may be mistaken for isolated AS, potentially impacting the treatment strategy and patient’s prognosis. Therefore, it is crucial to distinguish between these conditions, as failure to promptly diagnose CA may lead to considerable complications. The aim of this study is to investigate the diagnostic value of strain predictors in patients with concomitant CA and AS compared to isolated AS. Methods Forty-two patients with severe AS suspected of concomitant CA based on a comprehensive clinical evaluation were selected to undergo 99mTc-DPD scintigraphy. Those showing Perugini grade 2 or 3 tracer uptakes without evidence of monoclonal gammopathy were diagnosed with CA and underwent speckle-tracking echocardiography. Furthermore, strain analysis was performed to evaluate myocardial deformation, with a focus on detecting apical sparing and reduction in bull’s eye mapping, resulting in the characteristic “cherry on top” sign. Results Eight patients were diagnosed with CA, representing 19.0% of those suspected of concomitant CA and 7.8% of the overall cohort with severe AS. AF arrhythmia was significantly more frequent in these patients compared to those with isolated AS. Echocardiography findings revealed that E/E’ ratio and RALS were significantly higher in patients with concomitant CA, while GLS and mean basal LS were significantly lower in this group. The “cherry on top” sign was detected in 19 patients (45.2%), present in 100% of those with concomitant CA and AS, versus 32.4% in isolated AS cases (P = 0.04). This sign demonstrated a sensitivity of 100% and a specificity of 67.6% for predicting concomitant CA and AS. Conclusions In conclusion, the “cherry on top” sign was significantly more prevalent in patients with concomitant CA and AS, compared to those with isolated AS, demonstrating a sensitivity of 100% and a specificity of 67.6% for predicting concomitant CA. Moreover, RALS and E/E’ ratios were significantly higher in patients with concomitant CA, whereas GLS and mean basal LS were significantly lower in this group. |
| format | Article |
| id | doaj-art-ef72a1919b764b37bd313a9e735e1c3e |
| institution | DOAJ |
| issn | 1471-2261 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
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| series | BMC Cardiovascular Disorders |
| spelling | doaj-art-ef72a1919b764b37bd313a9e735e1c3e2025-08-20T02:39:48ZengBMCBMC Cardiovascular Disorders1471-22612024-12-012411810.1186/s12872-024-04415-8Strain echocardiography predictors in patients with concomitant cardiac amyloidosis and aortic stenosis: a cross-sectional studySamira Jafarisis0Shahab Masoumi1Naser Khezerlouy-Aghdam2Kia Seyed Toutounchi3Amirreza Jabbaripour Sarmadian4Sina Hamzehzadeh5Akram Shariati6Razieh Parizad7Venus Shahabi Rabori8Cardiovascular Research Center, Tabriz University of Medical SciencesCardiovascular Research Center, Tabriz University of Medical SciencesCardiovascular Research Center, Tabriz University of Medical SciencesCardiovascular Research Center, Tabriz University of Medical SciencesCardiovascular Research Center, Tabriz University of Medical SciencesCardiovascular Research Center, Tabriz University of Medical SciencesDepartment of Cardiology, School of Medicine, Urmia University of Medical SciencesCardiovascular Research Center, Tabriz University of Medical SciencesCardiology Department, Royal Albert Edward Infirmary, WWL NHS TrustAbstract Background Concomitant cardiac amyloidosis (CA) and aortic stenosis (AS) may be mistaken for isolated AS, potentially impacting the treatment strategy and patient’s prognosis. Therefore, it is crucial to distinguish between these conditions, as failure to promptly diagnose CA may lead to considerable complications. The aim of this study is to investigate the diagnostic value of strain predictors in patients with concomitant CA and AS compared to isolated AS. Methods Forty-two patients with severe AS suspected of concomitant CA based on a comprehensive clinical evaluation were selected to undergo 99mTc-DPD scintigraphy. Those showing Perugini grade 2 or 3 tracer uptakes without evidence of monoclonal gammopathy were diagnosed with CA and underwent speckle-tracking echocardiography. Furthermore, strain analysis was performed to evaluate myocardial deformation, with a focus on detecting apical sparing and reduction in bull’s eye mapping, resulting in the characteristic “cherry on top” sign. Results Eight patients were diagnosed with CA, representing 19.0% of those suspected of concomitant CA and 7.8% of the overall cohort with severe AS. AF arrhythmia was significantly more frequent in these patients compared to those with isolated AS. Echocardiography findings revealed that E/E’ ratio and RALS were significantly higher in patients with concomitant CA, while GLS and mean basal LS were significantly lower in this group. The “cherry on top” sign was detected in 19 patients (45.2%), present in 100% of those with concomitant CA and AS, versus 32.4% in isolated AS cases (P = 0.04). This sign demonstrated a sensitivity of 100% and a specificity of 67.6% for predicting concomitant CA and AS. Conclusions In conclusion, the “cherry on top” sign was significantly more prevalent in patients with concomitant CA and AS, compared to those with isolated AS, demonstrating a sensitivity of 100% and a specificity of 67.6% for predicting concomitant CA. Moreover, RALS and E/E’ ratios were significantly higher in patients with concomitant CA, whereas GLS and mean basal LS were significantly lower in this group.https://doi.org/10.1186/s12872-024-04415-8AmyloidosisAortic stenosisEchocardiographyStrain |
| spellingShingle | Samira Jafarisis Shahab Masoumi Naser Khezerlouy-Aghdam Kia Seyed Toutounchi Amirreza Jabbaripour Sarmadian Sina Hamzehzadeh Akram Shariati Razieh Parizad Venus Shahabi Rabori Strain echocardiography predictors in patients with concomitant cardiac amyloidosis and aortic stenosis: a cross-sectional study BMC Cardiovascular Disorders Amyloidosis Aortic stenosis Echocardiography Strain |
| title | Strain echocardiography predictors in patients with concomitant cardiac amyloidosis and aortic stenosis: a cross-sectional study |
| title_full | Strain echocardiography predictors in patients with concomitant cardiac amyloidosis and aortic stenosis: a cross-sectional study |
| title_fullStr | Strain echocardiography predictors in patients with concomitant cardiac amyloidosis and aortic stenosis: a cross-sectional study |
| title_full_unstemmed | Strain echocardiography predictors in patients with concomitant cardiac amyloidosis and aortic stenosis: a cross-sectional study |
| title_short | Strain echocardiography predictors in patients with concomitant cardiac amyloidosis and aortic stenosis: a cross-sectional study |
| title_sort | strain echocardiography predictors in patients with concomitant cardiac amyloidosis and aortic stenosis a cross sectional study |
| topic | Amyloidosis Aortic stenosis Echocardiography Strain |
| url | https://doi.org/10.1186/s12872-024-04415-8 |
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