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Published online: 2021-08-02
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Echocardiographic markers of cardiac amyloidosis in patients with heart failure and left ventricular hypertrophy

Jorge Melero Polo, Ana Roteta Unceta-Barrenechea, Pablo Revilla Martí, Raquel Pérez-Palacios, Anyuli Gracia Gutiérrez, Esperanza Bueno Juana, Alejandro Andrés Gracia, Saida Atienza Ayala, Miguel Ángel Aibar Arregui
DOI: 10.5603/CJ.a2021.0085
·
Pubmed: 34355777

open access

Ahead of print
Original articles
Published online: 2021-08-02

Abstract

Background: Cardiac amyloidosis (CA), following a non-invasive diagnosis, constitutes an increasingly prevalent heart failure (HF) etiology. This study aims to determine which echocardiography findings help to diagnose cardiac amyloidosis in patients with left ventricular hypertrophy (LVH) admitted for decompensated HF.

Methods: The present study is a retrospective observational study on a cohort of 85 LVH patients admitted for HF decompensation, in which 99mTc-DPD scanning was performed to rule out transthyretin CA. The echocardiographic findings obtained were compared between CA and non-CA groups.

Results: From a total number of 85 patients, 49 (57.6%) met the CA criteria and 36 (42.3%) were ruled out for the disease. Interventricular septum thickness (16 ± 3 mm vs. 14 ± 3 mm), left ventricular posterior wall thickness (14 ± 3 mm vs. 11 ± 2 mm), left ventricular mass (259 ± 76 g vs. 224 ± 53 g), left ventricular telediastolic diameter (48 ± 7 mm vs. 53 ± 6 mm), left ventricular telediastolic indexed volume (51 ± 18 cm3/m2 vs. 59 ± 16 cm3/m2), tricuspid annular plane systolic excursion (16 ± 5 mm vs. 20 ± 4 mm), right atrial area (27.4 ± 8.4 cm2 vs. 22.2 ± 5.7 cm2) and strain relative apical sparing (2.2 ± 0.9 vs. 1.03 ± 0.4; p = 0.04) were significantly associated with the diagnosis of CA.

Conclusions: In patients with LVH admitted for HF decompensation, there are several echocardiographic features (LVH, reduced left ventricular cavity size, strain relative apical sparing, right atrial dilation, and altered right ventricular function) that are associated with the diagnosis of cardiac amyloidosis.

Abstract

Background: Cardiac amyloidosis (CA), following a non-invasive diagnosis, constitutes an increasingly prevalent heart failure (HF) etiology. This study aims to determine which echocardiography findings help to diagnose cardiac amyloidosis in patients with left ventricular hypertrophy (LVH) admitted for decompensated HF.

Methods: The present study is a retrospective observational study on a cohort of 85 LVH patients admitted for HF decompensation, in which 99mTc-DPD scanning was performed to rule out transthyretin CA. The echocardiographic findings obtained were compared between CA and non-CA groups.

Results: From a total number of 85 patients, 49 (57.6%) met the CA criteria and 36 (42.3%) were ruled out for the disease. Interventricular septum thickness (16 ± 3 mm vs. 14 ± 3 mm), left ventricular posterior wall thickness (14 ± 3 mm vs. 11 ± 2 mm), left ventricular mass (259 ± 76 g vs. 224 ± 53 g), left ventricular telediastolic diameter (48 ± 7 mm vs. 53 ± 6 mm), left ventricular telediastolic indexed volume (51 ± 18 cm3/m2 vs. 59 ± 16 cm3/m2), tricuspid annular plane systolic excursion (16 ± 5 mm vs. 20 ± 4 mm), right atrial area (27.4 ± 8.4 cm2 vs. 22.2 ± 5.7 cm2) and strain relative apical sparing (2.2 ± 0.9 vs. 1.03 ± 0.4; p = 0.04) were significantly associated with the diagnosis of CA.

Conclusions: In patients with LVH admitted for HF decompensation, there are several echocardiographic features (LVH, reduced left ventricular cavity size, strain relative apical sparing, right atrial dilation, and altered right ventricular function) that are associated with the diagnosis of cardiac amyloidosis.

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Keywords

cardiac amyloidosis, echocardiography, heart failure, left ventricular hypertrophy

About this article
Title

Echocardiographic markers of cardiac amyloidosis in patients with heart failure and left ventricular hypertrophy

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2021-08-02

DOI

10.5603/CJ.a2021.0085

Pubmed

34355777

Keywords

cardiac amyloidosis
echocardiography
heart failure
left ventricular hypertrophy

Authors

Jorge Melero Polo
Ana Roteta Unceta-Barrenechea
Pablo Revilla Martí
Raquel Pérez-Palacios
Anyuli Gracia Gutiérrez
Esperanza Bueno Juana
Alejandro Andrés Gracia
Saida Atienza Ayala
Miguel Ángel Aibar Arregui

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