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Can echocardiography differentiate hereditary transthyretin amyloidosis from hypertrophic cardiomyopathy?
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Centre.
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Centre.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
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2013 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 34, no Supplement: 1, 213-213 p.Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Purpose: Hereditary transthyretin amyloidosis (ATTR) andhypertrophic cardiomyopathy (HCM) have many phenotypic similarities when examined by echocardiography. As the two conditions have different treatment strategies it is of importance to accurately diagnose these patients early in the disease. This study aimed to identify the most accurate echocardiographic method in differentiating these two conditions by using traditional and speckle tracking echocardiographyas well as myocardial texture analysis.

Methods: We investigated 40 healthy controls, 33 patients with biopsy proven ATTR and 20 with HCM. All patients had septal thickness >12 mm. We measured left ventricular (LV) global strain as intrinsic systolic function and LV E/e' to estimate filling pressures. We also tested septal cyclic integrated backscatter (cIBS) and septal entropy as both being measures for myocardial highly reflection pattern whereas cIBS showing motion of highly reflective echoes and entropy the distribution of highly reflective echoes.

Results: LV global strain, cIBS and E/e' were not useful in differentiating ATTR from HCM. However, septal entropy was found to be significantly different and showed an area under the curve from ROC analysis of 0.66 separating ATTR from HCM.

Conclusion: After using detailed analysis of different aspects of LV morphology and function we found that myocardial texture behavior from entropy analysis was the only method useful in differentiating patients with ATTR fromHCM.

Place, publisher, year, edition, pages
Oxford University Press, 2013. Vol. 34, no Supplement: 1, 213-213 p.
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-85325DOI: 10.1093/eurheartj/eht308.P1195ISI: 000327744601221OAI: oai:DiVA.org:umu-85325DiVA: diva2:693571
Conference
Congress of the European-Society-of-Cardiology (ESC), AUG 31-SEP 04, 2013, Amsterdam, NETHERLANDS
Available from: 2014-02-04 Created: 2014-01-31 Last updated: 2017-12-06Bibliographically approved

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Gustafsson, SandraGrönlund, ChristerMörner, StellanSuhr, OleLindqvist, Per
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