Arq. Bras. Cardiol. 2018; 111(3): 392-393
Three-dimensional Speckle Tracking Echocardiography in Amyloidosis: A New Assessment Method for a Rare Disease
DOI: 10.5935/abc.20180182
This Short Editorial is referred by the Research article "Right Atrial Deformation Analysis in Cardiac Amyloidosis – Results from the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Path Study".
Immunoglobulin deposition in the myocardium characterizes involvement of cardiac amyloidosis (CA). Fibrillary infiltration, which may happen in every heart cavity, leads to the restrictive cardiomyopathy phenotype, with complex pathophysiological mechanisms, which will result in the syndromic diagnosis of congestive heart failure. Diastolic dysfunction is dominant in most cases, and it may or may not, follow diverse levels of systolic dysfunction in the most advanced phases of the disease. Atrial remodeling by amyloid infiltration may contribute to cardiac output decrease by means of insufficient or nonexistent telediastolic atrial contraction. The onset of atrial electrical instability, ending in atrial fibrillation, highlights symptomatic worsening and these patients’ reserved prognosis.
Historically, the right cavities of the heart have been neglected in echocardiographic assessments. The complex morphology of the right ventricle (RV) has possibly contributed for the lack of reproducible data on echocardiographic cutting plans, diversely from the left ventricle (LV). The development of three-dimensional echocardiography (3DE) has allowed for a more accurate calculation of right ventricle volume and function in the diverse pathologies involving that chamber.
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