Echocardiography. 2026 Mar;43(3):e70428. doi: 10.1111/echo.70428.
ABSTRACT
PURPOSE: The aim of this study was to identify echocardiographic parameters which correlate with cardiac response to treatment in patients with light chain cardiac amyloidosis (AL-CA).
METHODS: We identified 39 patients with AL-CA treated at City of Hope and divided them into two cohorts; cardiac responders as defined by improvement in global longitudinal strain (GLS) over time and cardiac non-responders as defined by no change or worsening in GLS. We then compared baseline demographics and echocardiographic parameters between the two groups.
RESULTS: There were 16 cardiac responders and 23 cardiac non-responders identified. Correlation between changes in GLS was compared with change in other echocardiographic parameters. The change in GLS correlated with changes in left ventricular ejection fraction (LVEF) (r = -0.44, p < 0.01), stroke volume index (r = -0.05, p < 0.01), posterior wall thickness (r = 0.41, p = 0.01), right ventricular (RV) free wall strain (r = 0.66, p < 0.01), right ventricular four-chamber longitudinal strain (r = 0.67, p < 0.01), left atrial conduit strain (r = 0.46, p < 0.01), left atrial reservoir strain (r = -0.63, p < 0.01), and left atrial contractile strain (r = 0.48, p < 0.01). At less than 1 year, there was a positive correlation between change in GLS and change in RV free wall strain (r = 0.73, p < 0.01) and change in right ventricular four-chamber longitudinal strain (r = 0.75, p < 0.01).
CONCLUSION: Improvement in GLS correlated with improvement in RV and left atrial strain measurements in AL-CA patients receiving treatment. Changes in RV strain were seen early, within 1 year of treatment. Our study suggests that strain imaging in conjunction with cardiac biomarkers can provide a comprehensive assessment of cardiac response.
PMID:41879657 | DOI:10.1111/echo.70428