Cardiac Amyloidosis: Combined Use of Two‐Dimensional Echocardiography and Electrocardiography in Noninvasive Screening Before Biopsy

Sivaram, Chittur A.; Jugdutt, Bodh I.; Amy, R.M.; Basualdo, Carlos A.; Haraphongse, M; Shnitka, T. K.

doi:10.1002/clc.4960081004

Cited by 20 publications

(7 citation statements)

References 44 publications

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“…Constrictive pericarditis should be excluded by exploratory thoracotomy [12]. All patients also showed electrocardiographic abnormalities similar to those described previously [3,4,7], [13].…”

Section: Discussionmentioning

confidence: 69%

“…On the basis of two-dimensional échocardiographie find ings, biopsies were recommended and they resulted in the diagnosis of this disease [7,13].…”

Section: Two-dimensional Echocardiographymentioning

confidence: 99%

“…Cardiac involve ment is also the most common cause of death in patients with systemic amyloidosis [ 1 -6]. Early recognition, differ entiation from other cardiomyopathies and therapy are recurring clinical problems [7], Echocardiography is a use ful method for screening patients suspected of having car diac amyloid infiltration [6,[8][9][10][11][12][13][14]. Markedly increased ventricular free wall and septal thickness combined with variably depressed left-ventricular (LV) systolic function are typical findings in advanced cases [12,13].…”

Section: Introductionmentioning

confidence: 99%

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Echocardiographie Findings in Nine Patients with Cardiac Amyloidosis

Nishikawa¹,

Nishiyama²,

Nakanishi³

et al. 1990

Am J Noninvas Cardiol

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Nine patients with cardiac amyloidosis were studied by echocardiography and the échocardiographie abnormalities were then correlated with postmortem studies. All had congestive heart failure and autopsy-proven amyloidosis. M-mode features included; (1) small or normal left-ventricular (LV) dimensions; (2) thickened interventricular septa and LV posterior walls (89%); (3) left atrial enlargement (89%), and (4) reduced LV distensibility (78%, 100%) and contractility (22%, 44%). Serial M-mode echocardiography revealed that cardiac amylodosis was manifested initially more as diastolic than as systolic LV failure. The final stages in this disease were marked by severe impairment of both systolic and diastolic LV functions. Two-dimensional echocardiography provided additional features: (1) better appreciation of pericardial effusion (67%), and (2) a characteristic ‘granular sparkling’ appearance of ventricular walls (55%). These hyperrefractile myocardial echoes corresponded to histopathologically scattered amyloid mass deposits in 4 out of 5 cases. There was no relation between the amyloid deposit type and a hyperrefractile myocardial echo. Thus, cardiac involvement in systemic amyloidosis could be assessed noninvasively by M-mode and two-dimensional echocardiography.

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Section: Discussionmentioning

confidence: 69%

“…On the basis of two-dimensional échocardiographie find ings, biopsies were recommended and they resulted in the diagnosis of this disease [7,13].…”

Section: Two-dimensional Echocardiographymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Echocardiographie Findings in Nine Patients with Cardiac Amyloidosis

Nishikawa¹,

Nishiyama²,

Nakanishi³

et al. 1990

Am J Noninvas Cardiol

View full text Add to dashboard Cite

show abstract

“…These include low voltage on the electrocardiogram, decrease in rate of left ventricular diastolic filling, decreased left ventricular diameter/wall thickness ratio, increase in LV and RV wall thickness, LV mass and LV cross sectional area with normal chamber size and mild left atrial enlargement or an increase in echogenicity of the myocardium on echocardiography. The combination of echocardiographic and electrocardiographic features increases the diagnostic accuracy [13,20,21].…”

Section: Methodsmentioning

confidence: 99%

Is technetium-99 m-pyrophosphate scintigraphy valuable in the diagnosis of cardiac amyloidosis?

et al. 1990

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Amyloidosis is a systemic disease frequently involving the myocardium and leading to functional disturbances of the heart. Amyloidosis can mimic other cardiac diseases. A conclusive clinical diagnosis of cardiac involvement can only be made by a combination of different diagnostic methods. In 7 patients with myocardial amyloidosis we used a combined first-pass and static scintigraphy with technetium-99 m-pyrophosphate. There was only insignificant myocardial uptake of the tracer. The first-pass studies however revealed reduced systolic function in 4/7 patients and impaired diastolic function in 6/7 patients. Therefore, although cardiac amyloid could not be demonstrated in the static scintigraphy due to amyloid fibril amount and composition, myocardial functional abnormalities were seen in the first-pass study.

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“…Other causes include cardiomyopathy, which occasionally produces mural thrombosis. Cardiac involvement of amyloidosis is not uncommon in systemic amyloidosis associated with multiple myeloma, and is one of the causes of infiltrative cardiomyopathy in adults 1. However, cerebral embolism in relation to cardiac amyloidosis has rarely been reported in the neurology literature.…”

mentioning

confidence: 99%

Embolic Infarction Associated with Cardiac Amyloidosis

Cho

Kim

2005

J Clin Neurol

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Embolic cerebral infarction due to cardiac amyloidosis is rare. We report two patients with amyloidosis who developed cerebral infarcts. These embolic infarcts were probably related to cardiac involvement of amyloidosis, which was based on results of myocardial biopsy (Patient 1), and kidney biopsy and characteristic echocardiographic features including granular sparkling, restrictive cardiomyopathy and the presence of mural thrombus (Patient 2). Diffuse amyloid infiltration of the heart may have lead to impairment of myocardial function and subsequent mural thrombosis. Cardiomyopathy due to cardiac amyloidosis should be recognized as one of the causes of cardioembolic infarction.

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Cardiac Amyloidosis: Combined Use of Two‐Dimensional Echocardiography and Electrocardiography in Noninvasive Screening Before Biopsy

Cited by 20 publications

References 44 publications

Echocardiographie Findings in Nine Patients with Cardiac Amyloidosis

Echocardiographie Findings in Nine Patients with Cardiac Amyloidosis

Is technetium-99 m-pyrophosphate scintigraphy valuable in the diagnosis of cardiac amyloidosis?

Embolic Infarction Associated with Cardiac Amyloidosis

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