Cardiovascular Magnetic Resonance Imaging-Based Right Atrial Strain Analysis of Cardiac Amyloidosis
Jan Eckstein,
Vanessa Sciacca,
Hermann Körperich,
Lech Paluszkiewicz,
Elena Weise Valdés,
Wolfgang Burchert,
Muhammed Gerçek,
Martin Farr,
Philipp Sommer,
Christian Sohns,
Misagh Piran
Affiliations
Jan Eckstein
Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, University of Bochum, 32545 Bad Oeynhausen, Germany
Vanessa Sciacca
Clinic for Electrophysiology, Heart and Diabetes Center North Rhine Westphalia, University of Bochum, 32545 Bad Oeynhausen, Germany
Hermann Körperich
Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, University of Bochum, 32545 Bad Oeynhausen, Germany
Lech Paluszkiewicz
Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North-Rhine Westphalia, Ruhr-University of Bochum, 32545 Bad Oeynhausen, Germany
Elena Weise Valdés
Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, University of Bochum, 32545 Bad Oeynhausen, Germany
Wolfgang Burchert
Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, University of Bochum, 32545 Bad Oeynhausen, Germany
Muhammed Gerçek
Clinic for General and Interventional Cardiology, Heart and Diabetes Center North Rhine Westphalia, University of Bochum, 32545 Bad Oeynhausen, Germany
Martin Farr
Cardiogenetic Laboratory, Heart and Diabetes Center North-Rhine Westphalia, Ruhr-University of Bochum, 32545 Bad Oeynhausen, Germany
Philipp Sommer
Clinic for Electrophysiology, Heart and Diabetes Center North Rhine Westphalia, University of Bochum, 32545 Bad Oeynhausen, Germany
Christian Sohns
Clinic for Electrophysiology, Heart and Diabetes Center North Rhine Westphalia, University of Bochum, 32545 Bad Oeynhausen, Germany
Misagh Piran
Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, University of Bochum, 32545 Bad Oeynhausen, Germany
Background: Cardiac amyloidosis (CA) manifests in a hypertrophic phenotype with a poor prognosis, making differentiation from hypertrophic cardiomyopathy (HCM) challenging and delaying early treatment. The extent to which magnetic resonance imaging (MRI) quantifies the right atrial strain (RAS) and strain rate (RASR), providing valuable diagnostic information, is not yet clinically established. Aims: This study assesses diagnostic differences in the longitudinal RAS and RASR between CA and HCM patients, control subjects (CTRL) and CA subtypes in addition to the impact of atrial fibrillation (AF) on the right atrial function in CA patients. The RAS and RASR of tricuspid regurgitation (TR) patients are used to assess the potential for diagnostic overlap. Methods: RAS and RASR quantification was conducted via MRI feature-tracking for biopsy-confirmed CA patients with subtypes identified. Strain parameters were compared for CTRL, HCM and TR patients. Post hoc testing identified intergroup differences. Results: In total, 41 CA patients were compared to 47 CTRL, 20 HCM and 31 TR patients. Reservoir (R), conduit and booster RAS and RASRs allow for significant differentiation (p 0.8). CA patients with AF, in contrast to sinus rhythm, demonstrated a significantly impaired reservoir RAS and RASR and booster RASR. The discriminative power of RAS for CA vs. TR was insufficient (R: 10.6% ± 14.3% vs. 7.0% ± 6.0%, p = 0.069). Differentiation between 21 transthyretin and 20 light-chain amyloidosis subtypes was not achievable (R: 0.7% ± 1.0% vs. 0.7% ± 1.0%, p = 0.827). Conclusion: The MRI-derived RAS and RASR are impaired in CA patients and may support noninvasive differentiation between CA, HCM and CTRL.
