Predictive value of strain echocardiography in the diagnosis and outcome of restrictive cardiomyopathy in comparison with technetium -99m-pyrophosphate scintigraphy

After IEC clearance and CTRI registration, this Interventional single arm study will be conducted. Patients with diagnosed RCM at Kasturba hospital, Manipal will be enrolled in this pilot study. Cases are selected if willing to give informed consent. Brief details of the patient’s demographic and clinical history are obtained. This includes age, gender, weight, height and comorbidity history like Hypertension and Diabetes.12 lead ECG will be recorded. ECG gated conventional echocardiography along with strain echocardiography (layer specific strain) will be performed and recorded.  Strain echocardiographic analysis will be performed offline with the already available recorded echo images and will be stored for future references ,where LVEF, RV parameters, strain and strain rate will measured at baseline. Standard views will be taken with patient lying in left lateral decubitus position. Standard views like parasternal long axis and short axis at three levels of LV and apical 4,5 ,3 and 2 chamber views were recorded and stored. LVEF measurements will be taken by M mode and Simpson’s method. These images will be stored for offline analysis of strain. These patients will be later taken for single photon emission computed tomography gamma camera (SPECT-CT) where each subject will be intravenously injected with 740 MBq 99m -technetium -pyrophosphate radiotracer, post one hour after injection a planar scan will be performed and the images will be stored for post processing image reconstruction and data analysis. Strain echocardiographic parameters will be compared with 99m -technetium - pyrophosphate imaging results and assessed to see which among the two is a better predictor for the outcomes (sensitivity and specificity values will be calculated).