TY - JOUR T1 - Relative apical sparing of longitudinal strain using two-dimensional speckle-tracking echocardiography is both sensitive and specific for the diagnosis of cardiac amyloidosis JF - Heart JO - Heart SP - 1442 LP - 1448 DO - 10.1136/heartjnl-2012-302353 VL - 98 IS - 19 AU - Dermot Phelan AU - Patrick Collier AU - Paaladinesh Thavendiranathan AU - Zoran B Popović AU - Mazen Hanna AU - Juan Carlos Plana AU - Thomas H Marwick AU - James D Thomas Y1 - 2012/10/01 UR - http://heart.bmj.com/content/98/19/1442.abstract N2 - Background The diagnosis of cardiac amyloidosis (CA) is challenging owing to vague symptomatology and non-specific echocardiographic findings.Objective To describe regional patterns in longitudinal strain (LS) using two-dimensional speckle-tracking echocardiography in CA and to test the hypothesis that regional differences would help differentiate CA from other causes of increased left ventricular (LV) wall thickness.Methods and results 55 consecutive patients with CA were compared with 30 control patients with LV hypertrophy (n=15 with hypertrophic cardiomyopathy, n=15 with aortic stenosis). A relative apical LS of 1.0, defined using the equation (average apical LS/(average basal LS + mid-LS)), was sensitive (93%) and specific (82%) in differentiating CA from controls (area under the curve 0.94). In a logistic regression multivariate analysis, relative apical LS was the only parameter predictive of CA (p=0.004).Conclusions CA is characterised by regional variations in LS from base to apex. A relative ‘apical sparing’ pattern of LS is an easily recognisable, accurate and reproducible method of differentiating CA from other causes of LV hypertrophy. ER -