Abstract 10676: Left Atrial Strain is Associated with Supraventricular Tachycardia in Cardiac Amyloidosis Patients

Abstract

Introduction: In cardiac amyloidosis, supraventricular tachycardia is common. Probable mechanisms are left ventricular dysfunction resulting in left atrial disease, but also direct atrial amyloid infiltration. Although measurement of left ventricular global longitudinal strain is commonly used, the value of left atrial strain remains unclear. Hypothesis: Left atrial strain should be strongly associated with the occurrence of supraventricular tachycardia in cardiac amyloidosis patients. Methods: In 69 cardiac amyloidosis patients (75% male, mean age 65 years) in our Amyloidosis Expert Center, echocardiographic strain analysis was performed using EchoPAC (version 203, General Electric Healthcare) between March 2017 and May 2020. Results: Supraventricular tachycardia occurred in 34 (43%) cardiac amyloidosis patients, which were older (70±8 vs. 60±15 years, p=0.001) but had a similar left ventricular mass index and ejection fraction. Left atrial volume index was higher (56±21 vs. 45±18 ml/m 2 , p=0.02), left ventricular global longitudinal strain (11±4 vs. 14±4, p=0.004) and left atrial reservoir strain (12±9 vs. 23±16, p=0.001) were lower. Left atrial reservoir strain was associated with supraventricular tachycardia, independent of left ventricular global longitudinal strain or left atrial volume (B-value 0.88 (confidence interval 0.80 - 0.97), p=0.01). Conclusion: Low left atrial reservoir strain was associated with the occurrence of supraventricular tachycardia independent of left atrial volume and left ventricular global longitudinal strain and therefore a promising parameter in cardiac amyloidosis patients.