{
  "abstract": "Background/Objectives: Idiopathic carpal tunnel syndrome (CTS) can frequently precede the clinical diagnosis of transthyretin cardiac amyloidosis (ATTR-CA). This study aimed to comprehensively characterize the standard and advanced echocardiographic phenotype in a screening cohort of patients with CTS assessed for concurrent ATTR-CA. Methods: Thirty-three patients with idiopathic CTS underwent comprehensive standard and advanced echocardiography. The presence of concurrent ATTR-CA was assessed using 99mTc-DPD scintigraphy, allowing the stratification of the cohort into an amyloidosis group and a non-amyloidosis control group for comparative analysis. Results: Based on scintigraphy, 8 patients (24.2%) were diagnosed with presumptive ATTR-CA, acknowledging that AL amyloidosis was not systematically excluded, while 25 served as scintigraphy-negative controls. Standard echocardiography revealed greater wall thickness and worse diastolic function (p < 0.001) in the scintigraphy-positive group. Advanced imaging demonstrated profound left ventricular (LV) mechanical dysfunction, with severely reduced global longitudinal strain (p < 0.001) and a high prevalence of apical sparing (p < 0.001). Non-invasive myocardial work (MW) analysis showed a marked reduction in Global Constructive Work (p = 0.005) and Global Work Index (p = 0.017) in scintigraphy-positive patients, despite a relatively preserved LV ejection fraction. Multi-chamber strain analysis unmasked a pan-cardiac myopathy in the amyloid group, characterized by severe impairment of right ventricular (RV) global strain (p = 0.004) and profound depression of both left (p = 0.002) and right (p < 0.001) atrial reservoir strains. Conclusions: In patients with CTS, positive scintigraphy is characterized by severe, afterload-adjusted LV mechanical failure and profound biatrial and RV dysfunction. Advanced multi-chamber strain and MW indices show potential as non-invasive markers to help identify previously unrecognized pan-cardiac amyloid infiltration, guiding prompt diagnostic referral.",
  "abstract_shown": true,
  "affiliations": [
    "Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal.",
    "Escola Superior de Saúde, Universidade Técnica do Porto, 4200-072 Porto, Portugal.",
    "Department of Cardiology, Centro Hospitalar Universitário do São João, 4200-319 Porto, Portugal.",
    "Department of Rheumatology, Centro Hospitalar Universitário do São João, 4200-319 Porto, Portugal.",
    "RISE-Health, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Raquel Machado",
      "orcid": "0009-0006-3708-4529"
    },
    {
      "affs": [
        2
      ],
      "name": "Sara Maia",
      "orcid": "0000-0001-9778-7951"
    },
    {
      "affs": [
        2
      ],
      "name": "Emanuel Oliveira",
      "orcid": "0000-0001-9718-2047"
    },
    {
      "affs": [
        2
      ],
      "name": "Pedro Palma"
    },
    {
      "affs": [
        2
      ],
      "name": "Helena Moreira"
    },
    {
      "affs": [
        0
      ],
      "name": "Laura Vieira",
      "orcid": "0009-0002-0048-5290"
    },
    {
      "affs": [
        2
      ],
      "name": "Manuela Fonseca",
      "orcid": "0000-0002-5871-7552"
    },
    {
      "affs": [
        2
      ],
      "name": "Carla Sousa"
    },
    {
      "affs": [
        3
      ],
      "name": "Ana Martins",
      "orcid": "0000-0001-7581-4074"
    },
    {
      "affs": [
        3
      ],
      "name": "Sofia Pimenta"
    },
    {
      "affs": [
        4
      ],
      "name": "Janete Santos"
    },
    {
      "affs": [
        2,
        4
      ],
      "name": "Elisabete Martins",
      "orcid": "0000-0002-6944-2953"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/d5w3nan8z53cq.bib",
  "cited_by": 0,
  "doi": "10.3390/diagnostics16193124",
  "fulltext_url": "https://europepmc.org/articles/PMC13664157",
  "id": "d5w3nan8z53cq",
  "issns": [
    "2075-4418"
  ],
  "landing_url": "https://europepmc.org/article/MED/42882279",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "1312|Amyloidosis: Diagnosis, Treatment, Outcomes"
    ]
  ],
  "openalex": "W7214287695",
  "pdf_url": "https://europepmc.org/articles/PMC13664157?pdf=render",
  "pmcid": "PMC13664157",
  "pmid": "42882279",
  "published": "2026-09-25",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/d5w3nan8z53cq.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:16Z",
      "native_id": "MED:42882279",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42882279"
    }
  ],
  "subjects": [
    {
      "field": "biochemistry",
      "origin": "openalex:1312|Amyloidosis: Diagnosis, Treatment, Outcomes",
      "subfield": "molecular-biology"
    }
  ],
  "title": "Advanced Echocardiography and Myocardial Work in Idiopathic Carpal Tunnel Syndrome with Presumptive Concurrent Cardiac Amyloidosis: An Exploratory Cross-Sectional Study.",
  "title_text": "Advanced Echocardiography and Myocardial Work in Idiopathic Carpal Tunnel Syndrome with Presumptive Concurrent Cardiac Amyloidosis: An Exploratory Cross-Sectional Study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:16Z",
  "url": "https://research.draconitic.com/paper/d5w3nan8z53cq",
  "venue": "Diagnostics (Basel, Switzerland)",
  "versions": []
}