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心脏受累的淀粉样变性中的三尖瓣环:三维斑点追踪超声心动图MAGYAR-Path研究的详细分析

The tricuspid annulus in amyloidosis with cardiac involvement: Detailed analysis from the three-dimensional speckle tracking echocardiographic MAGYAR-Path Study.

作者信息

Nemes Attila, Rácz Gergely, Kormányos Árpád, Földeák Dóra, Borbényi Zita

机构信息

Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary.

Division of Haematology, Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary.

出版信息

Int J Cardiol Heart Vasc. 2022 Apr 21;40:101026. doi: 10.1016/j.ijcha.2022.101026. eCollection 2022 Jun.

Abstract

INTRODUCTION

Amyloidosis is a rare condition due to extracellular deposition of excessive amount of protein in parenchymal tissues including the heart. The present study aimed to test whether cardiac amyloidosis (CA) is associated with morphological and functional abnormalities of the tricuspid annulus (TA). For this aim, the results of patients having CA were compared to age- and gender-matched healthy controls by three-dimensional speckle-tracking echocardiography (3DSTE). Moreover, differences in TA parameters between light-chain CA (AL-CA) and transthyretin CA (TTR-CA) were studies as well.

MATERIALS AND METHODS

The study comprised 27 CA patients (mean age: 62.7 ± 9.1 years, 21 males), their results were compared to those of 20 age- and gender-matched healthy volunteers (59.3 ± 3.8 years, 13 males). Complete two-dimensional Doppler echocardiography and 3DSTE were performed in all CA patients and controls.

RESULTS

Dilated end-diastolic and end-systolic TA diameter, area and perimeter could be detected in all CA patients and in the AL-CA and TTR-CA subgroups, as well. Although only a few TTR-CA patients were involved, morphologic TA parameters proved to be tendentiously higher as compared to those of AL-CA patients. Functional parameters of TA were found to be reduced in CA patients, which were more deteriorated in AL-CA patients.

CONCLUSIONS

Dilated TA is associated with its functional deterioration in CA.

摘要

引言

淀粉样变性是一种罕见的疾病,由于包括心脏在内的实质组织中细胞外沉积了过量蛋白质。本研究旨在测试心脏淀粉样变性(CA)是否与三尖瓣环(TA)的形态和功能异常相关。为此,通过三维斑点追踪超声心动图(3DSTE)将CA患者的结果与年龄和性别匹配的健康对照进行比较。此外,还研究了轻链CA(AL-CA)和转甲状腺素蛋白CA(TTR-CA)之间TA参数的差异。

材料与方法

该研究包括27例CA患者(平均年龄:62.7±9.1岁,21例男性),将他们的结果与20例年龄和性别匹配的健康志愿者(59.3±3.8岁,13例男性)的结果进行比较。所有CA患者和对照均进行了完整的二维多普勒超声心动图和3DSTE检查。

结果

在所有CA患者以及AL-CA和TTR-CA亚组中均检测到舒张末期和收缩末期TA直径、面积和周长增大。尽管仅纳入了少数TTR-CA患者,但与AL-CA患者相比,TA形态学参数倾向于更高。发现CA患者TA的功能参数降低,在AL-CA患者中更严重。

结论

CA中TA扩张与其功能恶化相关。

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