{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T09:00:17Z","timestamp":1790586017408,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In wild\u2010type transthyretin amyloid cardiomyopathy (wtATTR\u2010CM), increased left ventricular wall thickness reflects amyloid infiltration rather than myocyte hypertrophy, and QRS voltage may not rise proportionally. Whether this electrical\u2013anatomical discordance marks myocardial dysfunction and adverse outcomes within established disease is uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively enrolled 220 consecutive patients with newly diagnosed wtATTR\u2010CM in a single\u2010centre cohort. LVH\u2013voltage discordance was defined as maximum LV wall thickness \u226512\u00a0mm with a Sokolow\u2013Lyon voltage &lt;\u00a03.5\u00a0mV. The primary outcome was absolute global longitudinal strain (GLS); secondary outcomes included impaired GLS (&lt;\u00a016%), serial GLS change, and clinical events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Discordance was present in 41.8%. Absolute GLS was lower with discordance (13.4\u00a0\u00b1\u00a02.8%\u00a0vs. 17.3\u00a0\u00b1\u00a03.5%), including after multivariable adjustment (\u03b2 \u22122.21, 95% CI \u22123.04 to \u22121.39;\n                      <jats:italic>p<\/jats:italic>\n                      &lt;\u00a00.001), without interaction by rhythm (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.52). Impaired GLS was more prevalent (81.5%\u00a0vs. 35.2%; adjusted prevalence ratio 1.66, 95% CI 1.28\u20132.15). The continuous QRS amplitude\u2010to\u2010wall\u2010thickness index correlated with absolute GLS (\u03c1 = 0.35;\n                      <jats:italic>p<\/jats:italic>\n                      &lt;\u00a00.001). Over a median 16.0 months, discordance was associated with cardiovascular death or first heart failure hospitalization (adjusted HR 3.88, 95% CI 1.43\u201310.52) and first heart failure hospitalization (adjusted HR 3.48, 95% CI 1.08\u201311.18); mortality estimates were imprecise. Among 142 patients with serial imaging, adjusted annual GLS decline was greater with discordance (\u22120.65\u00a0vs. \u22120.31 percentage points\/year).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In established wtATTR\u2010CM, LVH\u2013voltage discordance was associated with worse baseline GLS, a less favorable longitudinal GLS trajectory, and HF\u2010related outcomes. It may provide a simple marker for within\u2010disease phenotyping, but these findings require external validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70625","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T22:50:27Z","timestamp":1789599027000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["LVH\u2013Voltage Discordance and Myocardial Dysfunction in Wild\u2010Type Transthyretin Cardiomyopathy: A Prospective Cohort Study"],"prefix":"10.1111","volume":"43","author":[{"given":"Nihan","family":"Bahad\u0131r","sequence":"first","affiliation":[{"name":"Department of Cardiology Ordu University Faculty of Medicine  Ordu T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onur","family":"Osman \u015eeker","sequence":"additional","affiliation":[{"name":"Clinic of Cardiology University of Health Sciences T\u00fcrkiye Samsun Training 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