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Echocardiographic Evaluation of Systolic and Diastolic Function in Patients With Cardiac Amyloidosis

  • Author Footnotes
    † Drs. Liu and Niemann contributed equally to this article.
    Dan Liu
    Footnotes
    † Drs. Liu and Niemann contributed equally to this article.
    Affiliations
    Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany

    Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany
    Search for articles by this author
  • Author Footnotes
    † Drs. Liu and Niemann contributed equally to this article.
    Markus Niemann
    Footnotes
    † Drs. Liu and Niemann contributed equally to this article.
    Affiliations
    Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany

    Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany
    Search for articles by this author
  • Kai Hu
    Affiliations
    Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany

    Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany
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  • Sebastian Herrmann
    Affiliations
    Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany

    Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany
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  • Stefan Störk
    Affiliations
    Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany

    Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany
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  • Stefan Knop
    Affiliations
    Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
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  • Georg Ertl
    Affiliations
    Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany

    Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany
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  • Frank Weidemann
    Correspondence
    Corresponding author: Tel: 49-931-201-39012; fax: 49-931-201-639710
    Affiliations
    Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany

    Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany
    Search for articles by this author
  • Author Footnotes
    † Drs. Liu and Niemann contributed equally to this article.
      The typical appearance of cardiac amyloidosis using standard echocardiographic techniques is usually a late finding only in patients with relatively advanced stages of the disease. Early noninvasive identification of cardiac amyloidosis is of growing clinical importance. Newer echocardiographic techniques, including tissue Doppler imaging and deformation imaging (strain rate imaging and 2-dimensional speckle tracking), are powerful tools for quantifying regional myocardial motion and deformation. Using these advanced techniques, early functional impairment in cardiac amyloidosis may be detectable when the results of standard echocardiography are still normal or inconclusive. This review provides a comprehensive overview of the different echocardiographic approaches for the assessment of systolic and diastolic function in patients with cardiac amyloidosis. Special attention is paid to regional myocardial function assessed by tissue Doppler imaging, strain rate imaging, and 2-dimensional speckle-tracking imaging.
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      Linked Article

      • Rotational Mechanics of the Left Ventricle in Amyloid Light Chain Amyloidosis
        American Journal of CardiologyVol. 108Issue 11
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          In their extensive state-of-art report on the echocardiographic evaluation of systolic and diastolic function in patient with cardiac amyloidosis, Liu et al1 dedicated much space to tissue Doppler imaging, strain rate imagining, and 2-dimensional speckle-tracking imagining but made no mention of a particular behavior of left ventricular (LV) motion defined as twisting and untwisting. It consists of LV torsional deformation around the longitudinal axis, originating from the dynamic interaction between the systolic clockwise rotation of the base and the counterclockwise rotation of the apex, followed by untwisting during diastole.
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