Echocardiographic Manifestations of Infiltrative Cardiomyopathy

Child, John S.; Levisman, Jorge A.; Abbasi, Abdul S.; MacAlpin, Rex N.

doi:10.1378/chest.70.6.726

Cited by 103 publications

(33 citation statements)

References 14 publications

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“…The myocardial texture was abnormal and described as "granular sparkling." 26,[35][36][37] Subsequent changes in image processing produced a myocardial appearance that is less "granular" in appearance, but advanced amyloid heart disease still demonstrates an increased echogenicity of the myocardium and often of the valves ( Figure 5). The classic appearance of a restrictive pattern by Doppler echocardiography and associated increased echogenicity, biventricular thickening, and valvular infiltration is limited to patients in the end stage of the disease.…”

Section: Clinical Featuresmentioning

confidence: 99%

Diagnosis and Management of the Cardiac Amyloidoses

2005

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Section: Clinical Featuresmentioning

confidence: 99%

Diagnosis and Management of the Cardiac Amyloidoses

2005

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“…Moreover, 2 of the reported 7 patients showed small pericardial effusions. 7 In addition to the findings of LV wall thickening and increased LV mass, the characteristics of infiltrative cardiomyopathy include a septal/posterobasal free wall thickness ratio <1.3, increased maximal left atrial transverse dimension, reduced mitral valve closure (E-F) slope, and preserved ejection fraction (EF) >60%, even before clinically evident heart disease develops. 8 The right ventricular (RV) anterior wall thickness is reportedly significantly increased in patients with clinically significant amyloid infiltrative cardiomyopathy, and this is consistent with pathologic findings.…”

Section: Two-dimensional (2d) Echocardiography (Figure 2)mentioning

confidence: 99%

Echocardiographic Assessment of the Cardiac Amyloidoses

Koyama

Ikeda

2015

Circ J

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“…These changes in dimensions and wall thickness are consistent with those of amyloid heart disease reported in the literature. ' [5][6][7][8] The increased thickness of cardiac valves or of interatrial septum was not consistently identified in these series, in contrast to the findings reported in other studies. "4 In fact, only three patients (in two gingival biopsy samples were not obtained and in one results were positive) had increased thickness in the interatrial septum and three patients (in two gingi- The use of multiple views and ultrasonic windows was extremely important and allowed the evaluation of the myocardial characteristics in more than one section.…”

Section: Discussionmentioning

confidence: 77%

Prospective identification of patients with amyloid heart disease by two-dimensional echocardiography.

Nicolosi¹,

Pavan²,

Lestuzzi³

et al. 1984

Circulation

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The purpose of this study was to determine whether changes in myocardial wall echogenicity that suggest amyloid disease could be prospectively identified by a qualitative analysis of two-dimensional echocardiographic images. Two thousand seventy-eight consecutive echocardiograms obtained over a 14 month period were prospectively analyzed. The myocardial walls of 30 patients showed multiple, discrete, small highly refractive echoes; amyloid disease was not known or suspected in any of them. It was recommended that all 30 patients undergo gingival biopsy to confirm the diagnosis and biopsy was performed in 15 patients. The recommendation for biopsy was made only on the basis of two-dimensional echocardiographic images and was independent of findings regarding thickness of the walls or the dimensions of the cardiac chambers. Results of biopsy were positive in 11 patients and negative in four. We conclude that qualitative evaluation of two-dimensional echocardiographic images can identify changes in myocardial wall echogenicity that correlate with a result of gingival biopsy positive for amyloidosis. In patients who have a typical myocardial texture by twodimensional echocardiography and a positive gingival biopsy result, cardiac amyloidosis should be strongly suspected. Circulation 70, No. 3, 432-437. 1984. CLINICALLY SIGNIFICANT cardiac amyloidosis accounts for 5% to 10% of all forms of isolated noncoronary cardiomyopathy.' The two-dimensional echocardiographic features of the myocardium in amyloid heart disease have been described in patients with clinical and histologic evidence of diffuse amyloidosis. Cardiac walls are thickened and ventricular myocardium shows the presence of multiple, discrete, and small highly refractive echoes that are related to the amyloid deposits.1-l lThe purpose of this study was to determine whether changes in myocardial wall echogenicity that suggest amyloid disease could be detected prospectively by qualitative evaluation of the myocardial texture. MethodsTwo-dimensional echocardiograms. Two thousand seventy-eight consecutive echocardiograms obtained over a period of 14 months in our laboratory for diagnostic purposes were prospectively analyzed. Qualitative evaluation of the echocardiographic images was performed at the time of the examination. All patients in whom amyloidosis was known or suspected were excluded from the study. Two-dimensional echocardiograms were obtained with a Toshiba SSL53M phased-array sector scanner with a 2.4 MHz transducer. Parasternal, apical, and subcostal ultrasonic windows were used to obtain longitudinal, short-axis, four-chamber, and all the intermediate views required for complete analySiS. 12 The patients were examined in a semirecumbent position and in a partial left lateral position. Images were recorded on a 1/4 inch videocassette with a JVC 8300E video recorder. The images were processed and the display adjusted in a way to provide the best possible image for the qualitative evaluation of the myocardial texture. Images were consider...

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Echocardiographic Manifestations of Infiltrative Cardiomyopathy

Cited by 103 publications

References 14 publications

Diagnosis and Management of the Cardiac Amyloidoses

Diagnosis and Management of the Cardiac Amyloidoses

Echocardiographic Assessment of the Cardiac Amyloidoses

Prospective identification of patients with amyloid heart disease by two-dimensional echocardiography.

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