| Aims: To evaluate the left atrial(LA)strain(LAS)and left ventricular(LV)strain(LVS)in patients with cardiac amyloidosis(CA)and hypertensive heart disease(HHD)by cardiac magnetic resonance-feature tracking(CMR-FT)technique.To compare the differential diagnostic efficiency of LAS-related and LVS-related parameters and to investigate the correlations between LA deformation and LV parameters.Methods: Retrospective recruited 25 patients with CA confirmed by tissue biopsy,30sex-and age-matched HHD patients,and 20 healthy volunteers,divided them into CA group,HHD group and normal controls(NC)group.All LAS and LVS values were analyzed by FT module in CVI42 software,the main LVS parameters including global longitudinal strain(GLS),basal longitudinal strain(BLS),mid longitudinal strain(MLS),apical longitudinal strain(ALS),and the calculated relative apical sparing of strain(RAS)ratio;the main LAS parameters including LA reservoir strain(LASreservoir),LA conduit strain(LASconduit)and LA booster pump strain(LASbooster).The structural,functional,and strain parameters of LA and LV were compared by one-way analysis of variance(ANOVA)or non-parametric tests among three groups of subjects;the correlation between LA strain and LV parameters was analyzed by Pearson or Spearman’s correlation analysis;in addition,the value of LAS and LVS in differentiating CA from HHD was compared by receiver operating characteristic curves(ROC)analysis.Results: Compared with the NC group,both HHD and CA patients had impaired global and regional LVS,CA being the most severe(p < 0.05);All groups showed a trend of increasing absolute value of longitudinal strain(LS)from the basal to the apical myocardium,with the most obvious in the CA group,its relative apical sparing of LS(RASLS)ratio reached 0.91 ± 0.02,significantly higher than other two groups(HHD:0.72 ± 0.02,p < 0.001;controls: 0.56 ± 0.01,p < 0.001).In addition,all LAS values were reduced compared to the NC group,except for the LASbooster in the HHD group was preserved(p = 0.317)and CA was more pronounced(p < 0.05).ROC analysis showed that RASLS had the best differential diagnostic efficacy with an area under the curve(AUC)of 0.93(p < 0.001);The diagnostic efficacy of LA phases strain,with all AUCs greater than 0.85,and higher than GLS(AUC = 0.77,p = 0.001).Correlation analysis showed that LA deformation was significantly correlated with LV parameters(all p < 0.05);In all patients(both CA and HHD patients),LA phases strain was notably correlated with LVEF,LV-GLS and LV-ECV,with LASreservoir having the greatest correlation with LV-GLS(r =-0.807,p < 0.001).Conclusions: In distinguishing CA from HHD,LV-RS,LV-LS and LAS parameters all have certain values,with RASLS having the highest efficacy,followed by the LASreservoir.As a novel imaging marker,the LAS allows simultaneous assessment of LA function in three phases within a cardiac cycle;in addition to the coupling between atrial and ventricular functions(LAS was significantly correlated with LVEF,LV-GLS and LVECV),LAS was equivalent to an integrated indicator,which could provide additional useful information for the assessment of LV fibrosis and systolic-diastolic function. |
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