Serial Echocardiographic Observations in Patients With Primary Systemic Amyloidosis: An Introduction to the Concept of Early (Asymptomatic) Amyloid Infiltration of the Heart

Cueto-García, Luis; Tajik, A. Jamil; Kyle, Robert A.; Edwards, William D.; Greipp, Philip R.; Callahan, John A.; Shub, Clarence; Seward, James B.

doi:10.1016/s0025-6196(12)62409-4

Cited by 77 publications

(30 citation statements)

References 14 publications

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“…2,17 The presence of albuminuria higher than 1000 mg/24 h or a creatinine clearance of lower than 10 mL/min were considered indicative of renal disease. Neurologic disease was defined on the basis of orthostatic hypotension, GI motility abnormalities, or sensorimotor peripheral neuropathy.…”

Section: Classification Of Clinical Presentationmentioning

confidence: 99%

Immunoglobulin light chain variable (V) region genes influence clinical presentation and outcome in light chain–associated amyloidosis (AL)

Abraham

Geyer

Price-Troska

et al. 2003

Blood

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204

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Section: Classification Of Clinical Presentationmentioning

confidence: 99%

Immunoglobulin light chain variable (V) region genes influence clinical presentation and outcome in light chain–associated amyloidosis (AL)

Abraham

Geyer

Price-Troska

et al. 2003

Blood

Self Cite

204

193

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“…Thus, it is reasonable to assume that atrial reversals would be greater in primary than in familial amyloidosis and that this would result in an increase and not a decrease in LA active emptying fraction. 3,28,35 (5) A final limitation is the lack of endomyocardial biopsies in most of the patients in the present study. Nevertheless, those with biopsy-proven systemic amyloidosis and the typical echocardiographic features of cardiac involvement have confirmation by endomyocardial biopsy or autopsy.…”

Section: Study Limitationsmentioning

confidence: 91%

“…However, the prevalence of a restrictive diastolic transmitral flow velocity profile was higher in primary than in familial amyloidosis, indicating that LV diastolic pressure and, therefore, left atrial afterload were most likely higher in the former. 4,35 (4) Pulmonary vein flow was not assessed. Increased atrial reverse flow has been observed in cases with increased LV diastolic pressure.…”

Section: Study Limitationsmentioning

confidence: 99%

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Left atrial systolic function in primary and familial amyloidosis: Assessment from left atrial volume change

Moyssakis

Triposkiadis

Pantazopoulos

et al. 2004

Clinical Cardiology

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Summary:The severity of left ventricular involvement may differ between primary (PA) and familial amyloidosis (FA). This study examined whether differences in left atrial (LA) systolic function are also present. Twenty-eight patients (18 men, 10 women, aged 59 ± 12 years) with PA, 17 (11 men, 6 women, aged 40 ± 11 years) with FA, and 25 normal controls (18 men, 7 women, aged 56 ± 14 years) underwent transthoracic M-mode, two-dimensional, and Doppler echocardiography. Left atrial volumes were determined at mitral valve (MV) opening (maximal, Vmax), electrocardiographic P wave (onset of atrial systole, Vp), and MV closure (minimal, Vmin) from the apical two-and four-chamber views using the biplane area-length method. Left atrial systolic function was assessed with the LA active emptying volume (ACTEV) = Vp-Vmin and fraction (ACTEF) = ACTEV/Vp. The E/A ratio was increased (1.34 ± 0.93 vs. 0.89 ± 0.3), whereas deceleration time was decreased (168.1 ± 33.7 vs. 196.2 ± 34.2 ms) in PA compared with FA (p<0.05). Vmax and Vp were similar in PA and FA and greater than in the controls (46.6 ± 14 vs. 40 ± 11.4 vs. 27.1 ± 6.3 cm 3 /m 2 , p < 0.01, and 33.4 ± 11.6 vs. 29.7 ± 10.8 vs. 16.8 ± 3.8 cm 3 /m 2 , p < 0.01, respectively). The ACTEV was lower in PA and in the controls than in FA (6.7 ± 2 vs. 6.2 ± 2.2 vs. 8.5 ± 3.3, respectively, p < 0.05). The ACTEF was lower in PA than in FA and both were lower than those in the controls (20 ± 5% vs. 28 ± 7% vs. 36 ± 11%, respectively, p < 0.01). Despite a similar increase in LA volume, LA systolic dysfunction is more pronounced in PA than in FA. This is most likely due to the restrictive left ventricular physiology possibly associated with depressed LA contractility in the former.

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“…The specificity of the echocardiographyc findings increases in the presence of the clinical manifestations suggestive of myocardial amyloidosis. The earliest finding in cardiac amyloidosis is suggested by reduced diastolic mitral inflow velocities upon Doppler imaging (26,27). A granular sparkling texture of the myocardium with increased thickness is strongly suggestive of cardiac amyloid infiltration with a specificity approaching 81%.…”

Section: Cardiac Amyloidosismentioning

confidence: 99%

Cardiovascular Complications in Patients with AL Amyloidosis

Zangari¹,

Berno²,

Zhan³

et al. 2011

Amyloidosis - An Insight to Disease of Systems and Novel Therapies

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Serial Echocardiographic Observations in Patients With Primary Systemic Amyloidosis: An Introduction to the Concept of Early (Asymptomatic) Amyloid Infiltration of the Heart

Cited by 77 publications

References 14 publications

Immunoglobulin light chain variable (V) region genes influence clinical presentation and outcome in light chain–associated amyloidosis (AL)

Immunoglobulin light chain variable (V) region genes influence clinical presentation and outcome in light chain–associated amyloidosis (AL)

Left atrial systolic function in primary and familial amyloidosis: Assessment from left atrial volume change

Cardiovascular Complications in Patients with AL Amyloidosis

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