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RWT/SaVR-A Simple and Highly Accurate Measure Screening for Transthyretin Cardiac Amyloidosis
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
Cardiology Unit, Department of Medicine, Karolinska Institute, Sweden.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
Cardiology Unit, Department of Medicine, Karolinska Institute, Sweden.
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2022 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 11, no 14, article id 4120Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Cardiac amyloidosis is an underdiagnosed condition and simple methods for accurate diagnosis are warranted. We aimed to validate a novel, dual-modality approach to identify transthyretin cardiac amyloidosis (ATTR-CA), employing echocardiographic relative wall thickness (RWT), and ECG S-wave from aVR (SaVR), and compare its accuracy with conventional echocardiographic approaches.

MATERIAL AND METHODS: We investigated 102 patients with ATTR-CA and 65 patients with left ventricular hypertrophy (LVH), all with septal thickness > 14 mm. We validated the accuracy of echocardiographic measures, including RWT, RWT/SaVR, posterior wall thickness (PWT), LV mass index (LVMI), left atrial volume index (LAVI), global longitudinal strain (GLS), and relative apical sparing (RELAPS) to identify ATTR-CA diagnosed using DPD-scintigraphy or abdominal fat biopsy.

RESULTS: PWT, RWT, RELAPS, troponin, and RWT/SaVR were significantly higher in ATTR-CA compared to LVH. RWT/SaVR > 0.7 was the most accurate parameter to identify ATTR-CA (sensitivity 97%, specificity 90% and accuracy 91%). RELAPS was found to have much less accuracy (sensitivity 74%, specificity 76% and accuracy 73%).

CONCLUSION: We can confirm the very strong diagnostic accuracy of RWT/SaVR to identify ATTR-CA in patients with septal thickness > 14 mm. Given its high sensitivity and specificity, RWT/SaVR > 0.7 has the potential to implement as a non-invasive, simple, and widely available diagnostic tool when screening for ATTR-CA.

Place, publisher, year, edition, pages
MDPI, 2022. Vol. 11, no 14, article id 4120
Keywords [en]
ECG, cardiac amyloidosis, left ventricular hypertrophy, relative wall thickness, transthyretin
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-198312DOI: 10.3390/jcm11144120ISI: 000831448600001PubMedID: 35887882Scopus ID: 2-s2.0-85137207829OAI: oai:DiVA.org:umu-198312DiVA, id: diva2:1684742
Funder
Swedish Heart Lung Foundation, 20160787Swedish Heart Lung Foundation, 20200160Swedish Research Council, 2019–01338Available from: 2022-07-28 Created: 2022-07-28 Last updated: 2022-11-03Bibliographically approved

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Arnberg, ElsaLöfbacka, ViktorPilebro, BjörnLindqvist, Per

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