Heart failure & cardiomyopathies
Basal inferoseptal longitudinal strain deformation may indicate early cardiac involvement in wild-type carpal ATTR
Authors' conclusion
Basal inferoseptal LS impairment may indicate early cardiac involvement in individuals with carpal tunnel syndrome carrying ATTRwt deposits.
Study context
- Population
- Patients diagnosed with wild-type ATTR (ATTRwt) amyloidosis (mean age 77 ± 6 years; 88% male)patients diagnosed with wild-type ATTR (ATTRwt) amyloidosis
- Participants
- 81 patients
- Exposure
- Group 1 compared with Group 3; Group 1 vs Group 2 by segmental longitudinal strain
- Group 1n = 13
- Group 2n = 10
- Group 3n = 58
- Outcome
- Absolute global longitudinal strain (GLS)
Main finding
As reported in the abstract
Group 1
19.0
median · range in brackets 13.2–23.8 · %
- Higher in Group 1 compared with Group 3
- P < 0.001
Observational data: associations, not effects.
Further findings
- Apical-sparing ratio — Group 1
- median 0.66 (range in brackets 0.55–1.04)
- Brain natriuretic peptide (BNP) — Group 1
- median 13.5 (range in brackets 6–49) pg/mL
- Troponin-T — Group 1
- 0.012 (range in brackets 0.006–0.022) ng/mL
- Estimated glomerular filtration rate — Group 1
- 64 ± 9 mL/mL/1.73 m²
- Apical-sparing ratio — Lower in Group 1 compared with Group 3
- P < .001
- Brain natriuretic peptide (BNP) — Lower in Group 1 compared with Group 3
- P < .001
- Troponin-T — Lower in Group 1 compared with Group 3
- P < .001
- Estimated glomerular filtration rate — Remained preserved in Group 1
- P = .022
Basal inferoseptal longitudinal strain (LS) in Group 1, by troponin-T (elevated > 0.014 ng/mL vs lower values)
- Basal inferoseptal LS, elevated troponin-T vs lower values, as printed
- 13.9 ± 5.6% vs. 7.4 ± 1.8%
- Significantly lower in patients with elevated troponin-T (> 0.014 ng/mL)
- P = 0.046
- Segmental longitudinal strain (LS) differentiated Group 1 from Group 2
- Group 1 only
Identification of high troponin-T (AUC)
- Basal inferoseptal LS cutoff 9.1%
- AUC 0.833 (P = .005)
- Global longitudinal strain (GLS)
- AUC 0.306, P = .217
- BNP
- AUC 0.667, P = .292
- Left ventricle (LV) ejection fraction
- AUC 0.556, P = .743
Original publication
Basal inferoseptal longitudinal strain deformation may indicate early cardiac involvement in wild-type carpal ATTR. ESC Heart Fail. Published 16 February 2026. doi:10. 1093/ eschf/ xvag055
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