Distinguishing between cardiac amyloidosis and hypertrophic cardiomyopathy can be a challenge for clinicians as thickened heart walls are present in both conditions. Cardiac amyloidosis, where amyloid proteins accumulate in cardiac muscle, is often misdiagnosed as hypertrophic cardiomyopathy, which involves thickening of cardiac muscle. This can cause problems as these conditions require significantly different treatments.
A study in the journal Cardiology Research and Practice tested the potential of cardiovascular magnetic resonance imaging to distinguish between cardiac amyloidosis and hypertrophic cardiomyopathy. The imaging technology also incorporates a technique called tissue tracking which allows it to track cardiac movements and deformation.
Using cardiovascular magnetic resonance imaging data for 60 hypertrophic cardiomyopathy patients and 60 cardiac amyloidosis patients, the researchers compared right ventricular thickness and cardiac deformation parameters to see if these parameters could distinguish between the conditions.
They found that right ventricular thickness was significantly greater in patients with cardiac amyloidosis compared with those who had hypertrophic cardiomyopathy. Patients with cardiac amyloidosis also demonstrated a reduction in cardiac deformation parameters, including global radical peak strain, global longitudinal peak strain, and global circumferential peak strain.
Right ventricular thickness and cardiac deformation parameters demonstrated similar diagnostic accuracy for differentiating between hypertrophic cardiomyopathy and cardiac amyloidosis. However, the most powerful diagnostic factor was a combination of right ventricular thickness and right ventricular global longitudinal peak strain. The researchers hope that the technique could make diagnosis of either condition easier.
This article has been selected as Article of the Year by the Chief Editor of the journal, Dr. Terrence Ruddy. “This differentiation of cardiac amyloidosis from hypertrophic cardiomyopathy with cardiovascular magnetic resonance imaging has major clinical implications due to different treatment options and long-term prognosis," he said.
This blog post is distributed under the Creative Commons Attribution License (CC-BY). Illustration by David Jury/Samuel Jennings.