The combination of increased myocardial echogenicity and increased atrial septal thickness on 2-dimensional echocardiography was 60% sensitive and 100% specific for diagnosing cardiac amyloidosis.
Case-Control (n=70)
What is the sensitivity and specificity of 2-dimensional echocardiographic features for diagnosing cardiac amyloidosis in patients with left ventricular hypertrophy?
The combination of increased myocardial echogenicity and increased atrial septal thickness on 2D echocardiography provides 100% specificity for distinguishing cardiac amyloidosis from left ventricular hypertrophy.
Thirty-one patients with documented cardiac amyloidosis were compared to 39 control subjects with left ventricular hypertrophy to determine specific 2-dimensional echocardiographic features of amyloid. In 16 patients, increased myocardial echogenicity was present when a single short-axis view was examined, and had a sensitivity of 63% and a specificity of 74% for the diagnosis of amyloidosis. When complete echocardiograms were reviewed (15 patients), an improved sensitivity of 87% and specificity of 81% based on increased echogenicity was seen. Increased atrial septal thickness was present in 60% of amyloid patients and no controls. The combination of increased myocardial echogenicity and increased atrial thickness was 60% sensitive and 100% specific for the diagnosis of amyloidosis. The ratio of electrocardiographic voltage (S in V1 + R in V5 or V6) to left ventricular cross-sectional area also was examined. A ratio of less than 1.5 was 82% sensitive and 83% specific for amyloid (excluding the 2 patients with left bundle branch block), but added little to the diagnosis as determined from the 2-dimensional echocardiogram.
Falk et al. (1987) conducted a case-control in Cardiac amyloidosis (n=70). 2-dimensional echocardiography vs. Control subjects with left ventricular hypertrophy was evaluated on Diagnosis of cardiac amyloidosis. The combination of increased myocardial echogenicity and increased atrial septal thickness on 2-dimensional echocardiography was 60% sensitive and 100% specific for diagnosing cardiac amyloidosis.