ObjectiveTo analyze the diagnostic value of the three-dimensional speckle tracking imaging in cardiac involvement in patients with systemic immunoglobulin light chain(AL) amyloidosis.

MethodsEighty AL amyloidosis patients with normal left ventricular ejection fraction(LVEF) were investigated.According to whether the heart was involved, the patients were divided into the non-heart-affected group(group A, 35 cases) and heart-affected group(group B, 45 cases). The clinical data, serological parameters, conventional echocardiographic parameters and three-dimensional speckle tracking imaging parameters were compared between two groups, and the receiver operating characteristic curve(ROC) was used to analyze the specificity and sensitivity of three-dimensional speckle tracking imaging parameters in the diagnosis of AL amyloidosis.

ResultsThe level of amino-terminal B-type natriuretic peptide precursor(NT-proBNP) in group B was significantly higher than that in group A(P < 0.01). There was no statistical significance in the conventional ultrasound parameters between two groups(P>0.05). The overall left ventricular longitudinal strain(LVGLS), overall left ventricular area strain(LVGAS) and overall left ventricular radial strain(LVGRS) in group B were significantly lower than those in group A(P < 0.05 to P < 0.01). The results of ROC curve analysis showed that when the 16.12% of LVGLS was used as the cut-off point for diagnosing AL myocardial amyloidosis, the area under curve, sensitivity, specificity and Yuden index were the highest, which were 0.798, 94.18%, 86.84% and 0.619, respectively. The intra-group correlation coefficients of LVGLS, LVGAS and LVGRS were 0.908, 0.837 and 0.839, respectively.

ConclusionsThe ultrasound three-dimensional speckle tracking imaging has certain diagnostic value in cardiac involvement in patients with AL amyloidosis, is simple, non-invasive and worthy of recommending.