| ORIGINAL ARTICLE |
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| Year : 2021 | Volume
: 31
| Issue : 1 | Page : 17-22 |
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Early impairment of right ventricular morphology and function in transthyretin-related cardiac amyloidosis
Roberto Licordari1, Fabio Minutoli2, Antonino Recupero1, Mariapaola Campisi1, Rocco Donato2, Anna Mazzeo3, Giuseppe Dattilo1, Sergio Baldari2, Giuseppe Vita3, Concetta Zito1, Gianluca Di Bella1
1 Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, AOU “Policlinico G. Martino,” Messina, Italy
2 Department of Biomedical Sciences and Morphologic and Functional Images, University of Messina, Messina, Italy
3 Department of Clinical and Experimental Medicine, Neurology Unit, University of Messina, AOU “Policlinico G. Martino,” Messina, Italy
Correspondence Address:
Roberto Licordari
Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, AOU Policlinico G. Martino
Italy
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jcecho.jcecho_112_20
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Background: Our study aimed to evaluate right ventricular (RV) morphology and strain (S) in the early stage of familial transthyretin (TTR) cardiac amyloidosis (CA). Methods and Results: Thirty-seven patients with transthyretin mutation underwent 99mTc-3,3-diphosphono-1,2 propanodicarboxylic acid (99mTc-DPD) scans and/or cardiac magnetic resonance (CMR) to identify TTR CA. Each patient underwent echocardiography to quantify RV dimensions, tricuspid annular plane systolic excursion (TAPSE), systolic pulmonary artery pressure (sPAP), longitudinal (L) strain of the RV free wall, left ventricular (LV) septal thickness (ST), ejection fraction, E/E', LV global (G) L, radial (R), and circumferential (C) S. 99mTc-DPD and CMR revealed the accumulation in 22 of 37 patients (CA group) and no accumulation in 15 patients (no-CA group). Left ventricular (LV) septal thickness (ST) was higher (P < 0.0001) while LV ejection fraction and E/E' were lower (P < 0.05) in the CA group than the no-CA group. LV-global longitudinal strain (LS) was lower (P < 0.0001) in the CA-group than the no CA-group, whereas LV-global circumferential strain and LV-global radial strain were similar. The CA group showed higher values of RV dimensions (P < 0.05) and sPAP (0.02) and a lower (P = 0.002) TAPSE. Globally, RV-LS was lower (P = 0.005) in the CA group than the no-CA group. Basal and mid segments of the RV free wall showed a lower LS in the CA group than the no-CA group (P < 0.01), while apical S was similar between groups. Conclusions: RV deformation, particularly in basal and mid segments, is early impaired in CA.
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