ArticleEuropean heart journal. Imaging methods and practice2026
Integrating ECG and echocardiography to identify early-stage transthyretin amyloid cardiomyopathy.
Article in European heart journal. Imaging methods and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Aims: Current diagnostic criteria for transthyretin amyloid (ATTR) cardiomyopathy (ATTR-CM) emphasize increased left ventricular (LV) wall thickness, potentially delaying recognition of early myocardial involvement. We evaluated whether combining ECG (S-wave amplitude in lead aVR, SaVR) with echocardiographic relative apical sparing (RELAPS) enhances the detection of ATTR-CM in patients with absent or mild LV hypertrophy. Methods and results: In this single-centre, retrospective observational study, 39 ATTR patients (72 [64-78] years; 45% female) with interventricular septal thickness ≤13 mm were included. Diagnosis was confirmed by 99mTc-DPD scintigraphy and/or biopsy. Diagnostic performance of RELAPS-SaVR was tested against two comparator groups: patients with mild LV hypertrophy and no evidence of amyloidosis, in addition to age-matched healthy controls with normal cardiovascular status. Peripheral neuropathy was the dominant clinical presentation (66%, Conclusion: In this single-centre retrospective study, integrating SaVR with RELAPS improved the detection of ATTR-CM in patients with absent or mild LV hypertrophy. These findings support a simple, non-invasive strategy for early detection that merits prospective validation.
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