ABC | Volume 111, Nº3, September 2018

Original Article Nemes et al RA function in CA by 3DSTE Arq Bras Cardiol. 2018; 111(3):384-391 Table 5 – Comparison of 3DSTE-derived global and segmental peak right atrial strain parameters at atrial contraction in patients with cardiac amyloidosis and in matched controls AL-CA patients (n = 16) Controls (n = 15) p-value Global strain at atrial contraction RS (%) -6.4 ± 6.7 -6.2 ± 6.1 0.93 * CS (%) 10.6 ±11.9 7.8 ± 8.5 0.47 * LS (%) 4.0 ± 5.2 8.2 ± 5.5 0.02 * 3DS (%) -2.8 ± 4.9 -3.6 ± 4.4 0.62 * AS (%) 7.8 ± 8.1 15.9 ± 10.3 0.03 * Mean segmental strain at atrial contraction RS (%) -8.5 ± 6.0 -8.5 ± 4.8 0.99 * CS (%) 5.3 ± 6.2 8.6 ± 7.3 0.10 * LS (%) 6.5 ± 4.0 9.0 ± 5.7 0.20 * 3DS (%) -5.3 ± 4.6 -6.2 ± 4.5 0.57 * AS (%) 11.2 ± 6.8 17.2 ± 12.3 0.11 * 3DSTE: three-dimensional speckle-tracking echocardiography; CA: cardiac amyloidosis; 3DS: three-dimensional strain; AS: area strain; CS: circumferential strain; LS: longitudinal strain; RS: radial strain. Data expressed as mean ± standard deviation. * Unpaired Student t test. risk factors, haemodynamic reasons, local fibrosis or oedema. In a recent study, severe LA dysfunction could be demonstrated in AL-CA, therefore the role of LA-RA interactions could also not be excluded. 28 Segmental RA strain analyses showed RA regional differences, suggesting their different contributions to RA (dys)function, as mentioned before (non-uniformity of RA dysfunction). Further studies are needed to confirm our findings in a larger population, comparing results to other diseases with LV hypertrophy as well. It should also be examined whether the demonstrated pattern of RA Table 6 – Comparison of 3DSTE-derived segmental right atrial strain parameters at atrial contraction in patients with cardiac amyloidosis and in matched controls AL-CA patients (n = 16) Controls (n = 15) p-value RS basal (%) -9.6 ± 9.4 -8.5 ± 5.7 0.72 * RS mid (%) -7.2 ± 5.5 -7.5 ± 4.5 0.89 * RS superior (%) -9.0 ± 8.2 -10.2 ± 7.5 0.67 * CS basal (%) 4.6 ± 4.4 10.1 ± 10.5 0.07 * CS mid (%) 3.6 ± 4.4 8.4 ± 6.2 0.02 * CS superior (%) 10.6 ± 11.9 7.4 ± 9.8 0.42 * LS basal (%) 7.7 ± 4.0 8.9 ± 6.3 0.53 * LS mid (%) 6.8 ± 6.9 10.6 ± 7.3 0.12 * LS superior (%) 4.1 ± 5.7 7.0 ± 7.7 0.20 * 3DS basal(%) -5.4 ± 7.0 -6.0 ± 5.2 0.81 * 3DS mid(%) -4.2 ± 4.1 -6.0 ± 4.5 0.27 * 3DS superior (%) -6.8 ± 6.9 -7.1 ± 6.5 0.90 * AS basal (%) 9.9 ± 5.4 16.0 ± 10.6 0.06 * AS mid (%) 9.4 ± 9.1 18.2 ± 12.4 0.03 * AS superior (%) 15.9 ± 19.8 17.2 ± 22.3 0.87 * 3DSTE: three-dimensional speckle-tracking echocardiography; CA: cardiac amyloidosis; 3DS: three-dimensional strain; AS: area strain; CS: circumferential strain; LS: longitudinal strain; RS: radial strain. Data expressed as mean ± standard deviation. * Unpaired Student t test. dysfunction is specific or not for AL-CA, and whether it has or not a diagnostic or prognostic value. Limitations The limited number of patients with AL-CA is one of the most important limitations of the study. However, biopsy‑proven amyloidosis with cardiac involvement is a rare disease. Although the atrial septum is part of both atria, it was considered to be part of the RA in this study. 389