Clinical study of left ventricular structure and function in patients with Anderson–Fabry disease before and after enzyme replacement therapy

Author:

Huang Shuyue1ORCID,Wang Jian1,Zhang Wei2,Gao Feng1,Chen Yaodong1,Shui Wen1,Xing Xueqing1,Chen Shuqiong1ORCID,Mu Yixuan1

Affiliation:

1. Department of Ultrasound First Hospital of Shanxi Medical University Taiyuan Shanxi China

2. Department of Neurology First Hospital of Shanxi Medical University Taiyuan Shanxi China

Abstract

AbstractAimsCardiac left ventricular hypertrophy (LVH) is the most common manifestation of heart involvement in Anderson–Fabry disease (AFD). Conventional cardiac imaging is not sensitive enough to detect early signs of LVH in AFD. It remains uncertain whether enzyme replacement therapy (ERT) can prevent LVH progression and improve myocardial function. This study aimed to assess the effectiveness of two‐dimensional speckle tracking echocardiography (2D‐STE) in early detection of cardiac involvement in AFD and monitoring the efficacy of agalsidase alfa and agalsidase beta therapy.Methods and ResultsThirteen consecutive AFD patients and 12 healthy controls underwent standard transthoracic 2D, color Doppler, tissue Doppler echocardiography, and 2D strain analysis. Global longitudinal strain (GLS) and global circumferential strain (GCS) were measured. Diastolic strain rate (SR) was extracted. Compared to healthy subjects, AFD patients without LVH showed lower levels of GLS (p < 0.001) and SR (p = 0.01), while there was no difference in GCS (p = 0.82). Following treatment, apical circumferential strain (ACS) showed improvement (p = 0.01).ConclusionIn AFD patients without LVH, there was a decrease in global and segmental LS. Higher plasma Lyso‐GL‐3 concentrations were associated with elevated ACS values after ERT, indicating that ACS in AFD patients without LVH, albeit normal, is involved in early LV dysfunction.

Publisher

Wiley

Subject

Radiology, Nuclear Medicine and imaging

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