Heart failure & cardiomyopathies

Basal inferoseptal longitudinal strain deformation may indicate early cardiac involvement in wild-type carpal ATTR

ESC Heart FailPublished prospective evaluation

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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