ArticleQuantitative imaging in medicine and surgery2024
Relative apical sparing obtained with speckle tracking echocardiography is not a sensitive parameter for diagnosing light-chain cardiac amyloidosis.
Article in Quantitative imaging in medicine and surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.
- Relative apical sparing of left ventricular longitudinal strain for the diagnosis of cardiac amyloidosis: a systematic review and meta-analysis.Open heart · 2026Pooled it
- Imaging Advances in Light Chain Amyloidosis.Diagnostics (Basel, Switzerland) · 2026Review
- Visualization of the True Left Ventricular Apex on Transthoracic Echocardiography.Echocardiography (Mount Kisco, N.Y.) · 2026Article
- Left ventricular posterior wall thickness independently predicts the possibility of light-chain cardiac amyloidosis in hospitalized heart failure patients with monoclonal gammopathies.Cardiology journal · 2026Article
- First-phase ejection fraction as a potential early indicator for left ventricular function in cardiac amyloidosis.Quantitative imaging in medicine and surgery · 2025Article
- Advances in imaging-based diagnosis, prognosis, and response assessment in cardiac amyloidosis: a comprehensive multimodality review.Annals of nuclear medicine · 2025Review
- Atrial cardiomyopathy in cardiac amyloidosis: clinical imaging and manifestations.NPJ cardiovascular health · 2025Article
- Myocardial Mechanics and Valvular and Vascular Abnormalities in Cardiac Amyloidosis.Journal of clinical medicine · 2024Review
- The Relative Apical Sparing Strain Pattern in Severe Aortic Valve Stenosis: A Marker of Adverse Cardiac Remodeling.Journal of personalized medicine · 2024Article
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11 authors at 2 institutions in 1 country.
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Abstract
Background: Distinguishing light-chain cardiac amyloidosis (AL CA) from left ventricular wall thickening (LVWT) resulted from other etiologies has proven to be challenging. This study aimed to determine the sensitivity and specificity of relative apical sparing in diagnosing AL CA and investigate the differences in clinical and echocardiographic characteristics between AL CA patients with apical sparing and those with non-apical sparing. Methods: A total of 63 consecutive patients with AL CA, 102 consecutive patients with LVWT (including 51 hypertrophic cardiomyopathy (HCM) and 51 hypertension) and 33 healthy individuals were recruited retrospectively at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. Conventional and speckle tracking echocardiography were performed on all subjects. Results: Although wall thickening was observed in all patients, almost all functional parameters were worse in AL CA, except for relative apical longitudinal strain (LS) (P=0.906). Of 63 patients with AL CA, only 17.5% (n=11) showed an apical sparing pattern. Patients with apical sparing had poorer cardiac performance than those with non-apical sparing. Relative apical sparing showed the lowest diagnostic accuracy with an area under the curve (AUC) of 0.58 [95% confidence interval (CI): 0.49-0.67, sensitivity: 17.5%, specificity: 98.0%, P=0.095] to detect AL CA, but right ventricular strain (RVS) (AUC: 0.86, P<0.001) showed the highest among all echocardiographic parameters. When diagnosing AL CA patients with non-apical sparing, RVS continued to maintain excellent diagnostic accuracy (AUC: 0.84, P<0.001), followed by left atrial reservoir strain (LASr) (AUC: 0.77, P<0.001). Conclusions: The diagnostic value of relative apical sparing for AL CA was limited with low sensitivity. In clinical practice, the diagnosis of early AL CA patients should not solely rely on relative apical sparing.
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