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. 2020 Oct 30;7:590557. doi: 10.3389/fcvm.2020.590557

Figure 1.

Figure 1

Multi-modality imaging in cardiac amyloidosis. (A) Apical 4-chamber view showing increased left ventricular wall thickness (16 mm), dilated left atrium and myocardial speckling. (B) Parasternal short-axis view showing increased left ventricular wall thickness. (C) Global longitudinal strain on apical 3-chamber view showing presence of apical-sparing. (D) Bull's eye longitudinal strain showing evidence of apical-sparing. (E) Lateral E' Doppler velocity of 4.45 cm/s (N>10 cm/s). (F) Medial E' Doppler velocity of 3.19 cm/s (N>7 cm/s). (G) Mitral inflow with an MV peak E velocity of 1.16 m/s (N: 0.6–0.8 m/s). (H) Mitral inflow showing a reduction in deceleration time. (I) Cine CMR axial 3-chamber view showing concentric increase in left ventricular wall thickness and atrial dilatation. (J) Cine CMR axis 3-chamber showing evidence of widespread late gadolinium enhancement, particularly affecting basal inferior, basal anterior left ventricle and left atrium. (K) T1 mapping (Modified inversion recovery Look-Locker [MOLLI 3(3)3(3)5] 4-chamber view showing increase in left ventricular native T1 time (region of interest; mid-septum) consistent with amyloidosis; (L) T1 mapping MOLLI [3(3)3(3)5)] short-axis view, showing increase in left ventricular mean native T1 time (region of interest; mid septum) consistent with amyloidosis [T1 = 1,145 ms (N = 930–1,000 ms)]. (M) Bone Tracer Cardiac Scintigraphy using Tc99-DPD showing increased myocardial activity in the ventricles consistent with TTR amyloidosis. (N) Whole body 3 h sweep showing increased myocardial activity in the ventricles consistent with TTR amyloidosis; (O) Bone Tracer Cardiac Scintigraphy using Tc99-DPD showing increased myocardial activity in the ventricles consistent with TTR amyloidosis. Perugini score is 3 correlating with strong cardiac uptake with mild or absent bone uptake.