Key result
Cardiac amyloidosis is linked to a 2 mm thicker interventricular septum versus non-amyloid LVH.
Why the study?
Cardiac amyloidosis is an increasingly prevalent HF etiology, but it remained unclear which echocardiographic findings help identify it in patients with LVH admitted for decompensated HF.
Which echocardiographic findings help diagnose cardiac amyloidosis in patients with left ventricular hypertrophy admitted for decompensated heart failure?
Observational (n=85)
Blinded outcome assessment
No
Which echocardiographic findings help diagnose cardiac amyloidosis in patients with left ventricular hypertrophy admitted for decompensated heart failure?
Absolute Event Rate: 16% vs 14%
p-value: p=0.002
In patients with LVH admitted for decompensated HF, specific echocardiographic features including increased wall thickness, reduced LV cavity size, right atrial dilation, altered RV function, and strain relative apical sparing are significantly associated with cardiac amyloidosis.
Echocardiographic red flags may prompt earlier scintigraphy in LVH-HF; leaves open whether they improve noninvasive diagnostic algorithms in prospective cohorts.
BACKGROUND: Cardiac amyloidosis (CA), following a non-invasive diagnosis, constitutes an increasingly prevalent heart failure (HF) etiology. This study aims to determine which echocardiography findings help to diagnose CA in patients with left ventricular hypertrophy (LVH) admitted for decompensated HF. METHODS: The present study is a retrospective observational study on a cohort of 85 LVH patients admitted for HF decompensation, in which 99mTc-DPD scanning was performed to rule out transthyretin CA. The echocardiographic findings obtained were compared between CA and non-CA groups. RESULTS: From a total number of 85 patients, 49 (57.6%) met the CA criteria and 36 (42.3%) were ruled out for the disease. Interventricular septum thickness (16 ± 3 mm vs. 14 ± 3 mm), left ventricular posterior wall thickness (14 ± 3 mm vs. 11 ± 2 mm), left ventricular mass (259 ± 76 g vs. 224 ± 53 g), left ventricular end-diastolic diameter (48 ± 7 mm vs. 53 ± 6 mm), left ventricular end-diastolic indexed volume (51 ± 18 cm3/m2 vs. 59 ± 16 cm3/m2), tricuspid annular plane systolic excursion (16 ± 5 mm vs. 20 ± 4 mm), right atrial area (27.4 ± 8.4 cm2 vs. 22.2 ± 5.7 cm2) and strain relative apical sparing (2.2 ± 0.9 vs. 1.03 ± 0.4; p = 0.04) were significantly associated with the diagnosis of CA. CONCLUSIONS: In patients with LVH admitted for HF decompensation, there are several echocardiographic features (LVH, reduced left ventricular cavity size, strain relative apical sparing, right atrial dilation, and altered right ventricular function) that are associated with the diagnosis of cardiac amyloidosis.
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Polo et al. (2021) conducted an observational in Heart failure with left ventricular hypertrophy (n=85). Cardiac amyloidosis vs. Non-cardiac amyloidosis was evaluated on Interventricular septum thickness (mm) (p=0.002). In patients admitted for heart failure with left ventricular hypertrophy, cardiac amyloidosis was significantly associated with greater interventricular septum thickness (16 vs 14 mm) and other distinct echocardiographic features compared to non-amyloidosis causes.
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