Quantitative assessment of diastolic strain in patients with cardiac amyloidosis based on magnetic resonance feature tracking technology.

BACKGROUND

Cardiac amyloidosis (CA) is a rare, infiltrative restrictive cardiomyopathy. Late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR) imaging is an important basis for the diagnosis of CA. However, in the early stage of the disease, the deposition of pathological proteins is scarce, which may result in negative LGE. This study aims to explore the diagnostic value of diastolic strain (DS) of the myocardium in CA patients with negative LGE.

METHODS

A retrospective review was conducted from June 2020 to April 2024, including 41 CA patients and 18 healthy controls. Clinical data were analyzed, comparing CMR functional parameters, T1 values, extracellular volume (ECV), left ventricular peak filling rate (LVPFR), and DS parameters among the control, LGE-positive, and LGE-negative groups.

RESULTS

Compared to the LGE-positive group, the LGE-negative and control groups exhibited lower native T1 values, ECV, and higher left ventricular ejection fractions. Additionally, compared to the LGE-positive group, the control group had higher stroke volume, cardiac output, and cardiac index values. Moreover, the global peak DS rate radial (GPDSRR) two-dimensional (2D), global peak diastolic velocity circumferential (GPDVC) three-dimensional (3D), global peak diastolic velocity radial (GPDVR) 3D, and global peak DS rate circumferential (GPDSRC) 3D values of CA patients in the LGE-positive and LGE-negative groups were lower than those in the control group. The area under the receiver operating characteristic (ROC) curve in diagnosing LGE-negative CA for GPDSRC 3D, GPDSRR 2D, GPDVC 3D, and GPDVR 3D was 0.944, 0.917, 0.876, and 0.797, respectively.

CONCLUSIONS

The DS parameters demonstrate significant diagnostic value for LGE-negative CA patients and can serve as an imaging biomarker for diagnosing early cardiac involvement in CA patients to facilitate timely clinical treatment.