{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T03:22:42Z","timestamp":1777087362419,"version":"3.51.4"},"reference-count":18,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,9,17]],"date-time":"2018-09-17T00:00:00Z","timestamp":1537142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Progres Q38\/LF1 project"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec><jats:title>Aim of the study<\/jats:title><jats:p>To assess the diagnostic utility of a simplified approach to relative apical sparing of longitudinal strain (<jats:styled-content style=\"fixed-case\">RAS LS<\/jats:styled-content>) using only an apical four\u2010chamber view (A4C) in patients with <jats:styled-content style=\"fixed-case\">AL<\/jats:styled-content> amyloid cardiomyopathy (<jats:styled-content style=\"fixed-case\">ALAC<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively evaluated echocardiographic recordings of 20 patients with <jats:styled-content style=\"fixed-case\">ALAC<\/jats:styled-content>, 20 patients with Fabry disease\u2010related cardiomyopathy (<jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content>), and 20 patients with concentric hypertensive left ventricular hypertrophy (<jats:styled-content style=\"fixed-case\">HLVH<\/jats:styled-content>) matched for mean <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> mean thickness. Peak segmental <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content> values of the interventricular septum and lateral <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> wall were measured in the A4C using two\u2010dimensional speckle\u2010tracking echocardiography. <jats:styled-content style=\"fixed-case\">RAS LS<\/jats:styled-content> was calculated as average apical <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>\/(average basal <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>\u00a0+\u00a0average midventricular <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Relative apical sparing of longitudinal strain values in patients with <jats:styled-content style=\"fixed-case\">ALAC<\/jats:styled-content> (1.23\u00a0\u00b1\u00a00.64) were significantly higher than those in <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> patients (0.75\u00a0\u00b1\u00a00.19, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05) as well as in individuals with <jats:styled-content style=\"fixed-case\">HLVH<\/jats:styled-content> (0.75\u00a0\u00b1\u00a00.23, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05), but with a significant overlap. The optimal <jats:styled-content style=\"fixed-case\">RAS LS<\/jats:styled-content> value differentiating <jats:styled-content style=\"fixed-case\">ALAC<\/jats:styled-content> from <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">HLVH<\/jats:styled-content> with 70% sensitivity and 75% specificity was 0.88 (<jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content> 0.79). In multivariate modeling, <jats:styled-content style=\"fixed-case\">RAS LS<\/jats:styled-content> was significantly additive to traditional predictors of <jats:styled-content style=\"fixed-case\">ALAC<\/jats:styled-content> (low <jats:styled-content style=\"fixed-case\">QRS<\/jats:styled-content> voltage and pseudoinfarct <jats:styled-content style=\"fixed-case\">ECG<\/jats:styled-content> patterns, pericardial effusion, E\/e\u2032 ratio, E\u2010wave deceleration time; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05 for all models).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Simplified <jats:styled-content style=\"fixed-case\">RAS LS<\/jats:styled-content> evaluation represents an attractive approach for diagnostics of <jats:styled-content style=\"fixed-case\">ALAC<\/jats:styled-content>. However, because of considerable overlap with other disorders with hypertrophic phenotype, the analysis of <jats:styled-content style=\"fixed-case\">RAS LS<\/jats:styled-content> in the A4C should be combined with other traditional echocardiographic and <jats:styled-content style=\"fixed-case\">ECG<\/jats:styled-content> predictors in differentiating <jats:styled-content style=\"fixed-case\">ALAC<\/jats:styled-content> from other forms of concentric <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> wall thickening.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.14132","type":"journal-article","created":{"date-parts":[[2018,9,18]],"date-time":"2018-09-18T05:28:47Z","timestamp":1537248527000},"page":"1764-1771","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Simplified apical four\u2010chamber view evaluation of relative apical sparing of longitudinal strain in diagnosing <scp>AL<\/scp> amyloid cardiomyopathy"],"prefix":"10.1111","volume":"35","author":[{"given":"Michal","family":"Fikrle","sequence":"first","affiliation":[{"name":"2nd Department of Medicine \u2013 Department of Cardiovascular Medicine First Faculty of Medicine Charles University in Prague and General University Hospital in Prague  Prague Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9415-5243","authenticated-orcid":false,"given":"Tomas","family":"Palecek","sequence":"additional","affiliation":[{"name":"2nd Department of Medicine \u2013 Department of Cardiovascular Medicine First Faculty of Medicine Charles University in Prague and General University Hospital in Prague  Prague Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josef","family":"Marek","sequence":"additional","affiliation":[{"name":"2nd Department of Medicine \u2013 Department of Cardiovascular Medicine First Faculty of Medicine Charles University in Prague and General University Hospital in Prague  Prague Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1816-5634","authenticated-orcid":false,"given":"Petr","family":"Kuchynka","sequence":"additional","affiliation":[{"name":"2nd Department of Medicine \u2013 Department of Cardiovascular Medicine First Faculty of Medicine Charles University in Prague and General University Hospital in Prague  Prague Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ales","family":"Linhart","sequence":"additional","affiliation":[{"name":"2nd Department of Medicine \u2013 Department of Cardiovascular Medicine First Faculty of Medicine Charles University in Prague and General University Hospital in Prague  Prague Czech 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