{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T00:24:33Z","timestamp":1793924673890,"version":"4.8.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T00:00:00Z","timestamp":1684195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003500","name":"University of Padova","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003500","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer Inc","doi-asserted-by":"publisher","award":["RSF-2016-2016-02363774"],"award-info":[{"award-number":["RSF-2016-2016-02363774"]}],"id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005890","name":"Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005890","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013116","name":"University Research","doi-asserted-by":"publisher","award":["BIRD2222_01"],"award-info":[{"award-number":["BIRD2222_01"]}],"id":[{"id":"10.13039\/100013116","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Myocardial longitudinal strain (LS) by two-dimensional (2D) speckle-tracking echocardiography has a diagnostic and prognostic role in cardiac amyloidosis (CA). Typically, the apical segments of the left ventricle (LV) are less affected by LS abnormalities, a finding called relative apical sparing (RELAPS). Whether a variable burden of CA might explain the RELAPS remains unknown.<\/jats:p>\n                  <jats:p>We aimed to evaluate the extent, distribution, and deposition pattern of amyloid in autopsy hearts of CA patients and to correlate the histopathology findings with 2D echocardiography.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>This is a retrospective study of whole heart specimens of CA patients who died and underwent autopsy and 2D echocardiography. Amyloid burden quantification was assessed by histomorphometry in each segment at different LV levels. The LS analysis results were compared with the amyloid burden and the base-to-apex distribution.<\/jats:p>\n                  <jats:p>Histopathology investigation of 27 hearts with CA [immunoglobulin light chains (AL) 17 cases and transthyretin (ATTR) 10 cases] demonstrated an amyloid base-to-apex gradient. In 11 CA patients with 2D echocardiography, analysis of LS and histological amyloid burden allowed to identify different patterns: RELAPS (8 cases, 73%), with (2) or without (6) amyloid gradient, normal or mildly reduced LS with diffuse low amyloid (2, 18%), and severely reduced LS with diffuse high amyloid (1, 9%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The typical RELAPS pattern at echocardiography is not always explained by a base-to-apex gradient of amyloid burden at histopathology, suggesting that RELAPS might be an epiphenomenon of complex interactions among amyloid infiltration, myocardial structure, and adaptation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jead107","type":"journal-article","created":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T09:00:57Z","timestamp":1684227657000},"page":"1258-1268","source":"Crossref","is-referenced-by-count":43,"title":["Relative apical sparing in cardiac amyloidosis is not always explained by an amyloid gradient"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9528-4883","authenticated-orcid":false,"given":"Monica","family":"De Gaspari","sequence":"first","affiliation":[{"name":"Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua , Via N. Giustiniani 2 - 35121 Padua , Italy"},{"name":"Cardiovascular Pathology Unit, University Hospital of Padua , Via A. Gabelli 61 - 35121 Padua , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Sinigiani","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua , Via N. Giustiniani 2 - 35121 Padua , Italy"},{"name":"Cardiology Unit, University Hospital of Padua , Via N. Giustiniani 2 - 35121 Padua , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0574-4052","authenticated-orcid":false,"given":"Laura","family":"De Michieli","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua , Via N. Giustiniani 2 - 35121 Padua , Italy"},{"name":"Cardiology Unit, University Hospital of Padua , Via N. Giustiniani 2 - 35121 Padua , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mila","family":"Della Barbera","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua , Via N. Giustiniani 2 - 35121 Padua , Italy"},{"name":"Cardiovascular Pathology Unit, University Hospital of Padua , Via A. Gabelli 61 - 35121 Padua , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua , Via N. Giustiniani 2 - 35121 Padua , Italy"},{"name":"Cardiovascular Pathology Unit, University Hospital of Padua , Via A. Gabelli 61 - 35121 Padua , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8814-2577","authenticated-orcid":false,"given":"Gaetano","family":"Thiene","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua , Via N. Giustiniani 2 - 35121 Padua , Italy"},{"name":"Cardiovascular Pathology Unit, University Hospital of Padua , Via A. Gabelli 61 - 35121 Padua , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabino","family":"Iliceto","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua , Via N. Giustiniani 2 - 35121 Padua , Italy"},{"name":"Cardiology Unit, University Hospital of Padua , Via N. Giustiniani 2 - 35121 Padua , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7645-6993","authenticated-orcid":false,"given":"Martina","family":"Perazzolo Marra","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua , Via N. Giustiniani 2 - 35121 Padua , Italy"},{"name":"Cardiology Unit, University Hospital of Padua , Via N. Giustiniani 2 - 35121 Padua , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2823-4090","authenticated-orcid":false,"given":"Donato","family":"Mele","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua , Via N. Giustiniani 2 - 35121 Padua , Italy"},{"name":"Cardiology Unit, University Hospital of Padua , Via N. 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