Heart failure & cardiomyopathies
Relative apical sparing in cardiac amyloidosis is not always explained by an amyloid gradient
Authors' conclusion
The typical RELAPS pattern at echocardiography is not always explained by a base-to-apex gradient of amyloid burden at histopathology, suggesting that RELAPS might be an epiphenomenon of complex interactions among amyloid infiltration, myocardial structure, and adaptation.
Study context
- Population
- Autopsy hearts of patients with cardiac amyloidosis who died and underwent autopsy and 2D echocardiography11 with 2D echocardiography
- Participants
- 27 participants
- Exposure
- AL vs ATTR
- ALn = 17
- ATTRn = 10
- Outcome
- Extent, distribution and deposition pattern of amyloid (histomorphometry) correlated with left ventricle (LV) longitudinal strain on 2D echocardiography
Methodological detailshistopathology–echocardiography correlation
- Histopathology–echocardiography correlation
Main finding
As reported in the abstract
- Relative apical sparing (RELAPS)
- 8 cases, 73%
- RELAPS with amyloid gradient
- 2
- RELAPS without amyloid gradient
- 6
- Normal or mildly reduced longitudinal strain (LS) with diffuse low amyloid
- 2, 18%
- Severely reduced LS with diffuse high amyloid
- 1, 9%
Observational data: associations, not effects.
Original publication
Relative apical sparing in cardiac amyloidosis is not always explained by an amyloid gradient. Eur Heart J Cardiovasc Imaging. Published 16 May 2023. doi:10.
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