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Licordari et al. Vessel Plus 2022;6:12 Vessel Plus
DOI: 10.20517/2574-1209.2021.86

Original Article Open Access

Mid-basal left ventricular longitudinal dysfunction as

a prognostic marker in mutated transthyretin-related
cardiac amyloidosis

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Roberto Licordari , Fabio Minutoli , Francesco Cappelli , Antonio Micari , Luigi Colarusso , Federico
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Antonio Francesco Di Paola , Mariapaola Campisi , Antonino Recupero , Anna Mazzeo , Gianluca Di Bella 1
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Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina 98125, Italy.
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Department of Biomedical Sciences and Morphologic and Functional Images, University of Messina, Messina 98125, Italy.
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Tuscan regional amyloid center, Careggi University Hospital, Firenze 50134, Italy.
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Neurology Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina 98125, Italy.
Correspondence to: Dr. Roberto Licordari, Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, Via
Consolare Valeria 1, University of Messina, Messina 98125, Italy. E-mail: robertolicordari@gmail.com
How to cite this article: Licordari R, Minutoli F, Cappelli F, Micari A, Colarusso L, Di Paola FAF, Campisi M, Recupero A, Mazzeo
A, Di Bella G. Mid-basal left ventricular longitudinal dysfunction as a prognostic marker in mutated transthyretin-related cardiac
amyloidosis. Vessel Plus 2022;6:12. https://dx.doi.org/10.20517/2574-1209.2021.86
Received: 11 Jun 2021 First Decision: 17 Aug 2021 Revised: 26 Aug 2021 Accepted: 12 Oct 2021 Published: 17 Feb 2022
Academic Editors: Alexander D. Verin, Ugolino Livi, Gianfranco Sinagra Copy Editor: Yue-Yue Zhang Production Editor: Yue-
Yue Zhang
Abstract
Aim: Mutated transthyretin (TTRv) cardiac amyloidosis (CA) represents an uncommon form of CA. Our study
aimed to assess the best echocardiographic prognostic parameter in the early stage of TTRv amyloidosis with
cardiomyopathy.

Methods: In total, 99 patients with TTRv in New York Heart Association class I or II and with no clinical history of
previous cardiac disease were studied. Assessment with 99m Tc-DPD whole-body scan showed CA in 46 patients. At
the first medical contact, an echocardiographic examination was performed. In addition to conventional left
ventricular (LV), echocardiographic measurements [ejection fraction (EF), dimensions and diastolic function,
global longitudinal strain (GLS), longitudinal strain of the 4 apical segments, longitudinal strain of the 12 mid-basal
segments (MBLS)] and their ratio [relative regional strain ratio (RRSR)] were obtained. Patient outcome was
evaluated during a follow-up with an average duration of six years. Cardiac death and appropriate implantable
cardiac defibrillator (ICD) shock were considered major events.

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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