Diagnostic evaluation of cardiac amyloidosis using echocardiography, ECG, and right heart catheterization revealed biventricular hypertrophy, restrictive filling, and ST-T abnormalities in 71%.
Observational (n=14)
What are the characteristic echocardiographic, ECG, and right heart catheterization findings in patients with cardiac amyloidosis?
Echocardiography, ECG, and right heart catheterization reveal characteristic findings of biventricular hypertrophy, restrictive filling, and specific ECG abnormalities that should raise clinical suspicion for cardiac amyloidosis.
AIMS: To characterize patients with cardiac amyloidosis using echocardiography, electrocardiogram (ECG) and right heart catheterization (RHC). METHODS AND RESULTS: Fourteen patients with biopsy verified light chain or transthyretin cardiac amyloidosis were included. All patients had heart failure with markedly elevated NT-proBNP. Echocardiography demonstrated biventricular hypertrophy, left atrial enlargement and normal to slightly reduced left ventricular ejection fraction. Tissue Doppler septal é was low and median E/é was high. Within 6 months RHC was performed in eight of the patients. The restrictive filling pattern demonstrated by echocardiography corresponded well to median pulmonary wedge pressure (21 mmHg). Systolic pulmonary artery pressure (SPAP) was increased, whereas cardiac output and stroke volume were seen to be decreased with both methods. ECG demonstrated: low voltage (36%), abnormal R-progression (65%), ST-T abnormalities (71%) and high incidence of fibrillation (36%). In addition, a case report following the treatment of melphalan and dexamethasone is presented with improvement of hypertrophy, SPAP, left ventricular mass and é. CONCLUSION: These findings should lead to a suspicion of cardiac amyloidosis and suggest further investigation.
Granstam et al. (Tue,) conducted a observational in Cardiac amyloidosis (n=14). Echocardiography, ECG and right heart catheterization was evaluated on Echocardiographic, ECG, and hemodynamic characteristics. Diagnostic evaluation of cardiac amyloidosis using echocardiography, ECG, and right heart catheterization revealed biventricular hypertrophy, restrictive filling, and ST-T abnormalities in 71%.