Document Detail

Circadian rhythm of blood pressure reflects the severity of cardiac impairment in familial amyloid polyneuropathy.
MedLine Citation:
PMID:  22709469     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Cardiac amyloidosis due to familial amyloid polyneuropathy (FAP) includes restrictive cardiomyopathy, thickened cardiac walls, conduction disorders and cardiac denervation. Impaired blood pressure variability has been documented in FAP related to the Val30Met mutation.
AIMS: To document blood pressure variability in FAP patients with various mutation types and its relationship to the severity of cardiac involvement.
METHODS: Blood pressure variability was analysed in 49 consecutive FAP patients and was compared with a matched control population. Cardiac evaluation included echocardiography, right heart catheterization, electrophysiological study, Holter electrocardiogram and metaiodobenzylguanidine (MIBG) scintigraphy.
RESULTS: A non-dipping pattern was found in 80% of FAP patients and in 35% of control patients (P<0.0001); this was due to a significantly lower diurnal blood pressure in FAP patients (FAP group, 113±21mmHg; control group, 124±8mmHg; P<0.0001), whereas nocturnal blood pressures were similar. Among FAP patients, a non-dipping pattern was significantly associated with haemodynamic involvement, cardiac thickening or conduction disorders. These associations did not depend on the average blood pressure levels. Impaired blood pressure variability was more frequent and more pronounced in patients with multiple criteria for severe cardiac amyloidosis.
CONCLUSION: Low blood pressure variability is common in cardiac amyloidosis due to FAP. A non-dipping pattern was more frequently observed in FAP patients with haemodynamic impairment, cardiac thickening or conduction disorders. It is suggested that impairment of circadian rhythm of blood pressure reflects the severity of cardiac amyloidosis due to FAP.
Vincent Algalarrondo; Ludivine Eliahou; Isabelle Thierry; Abdeslam Bouzeman; Madalina Dasoveanu; Claude Sebag; Ghassan Moubarak; Dominique Le Guludec; Didier Samuel; David Adams; Sylvie Dinanian; Michel S Slama
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Publication Detail:
Type:  Journal Article     Date:  2012-05-29
Journal Detail:
Title:  Archives of cardiovascular diseases     Volume:  105     ISSN:  1875-2128     ISO Abbreviation:  Arch Cardiovasc Dis     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-06-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101465655     Medline TA:  Arch Cardiovasc Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  281-90     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Masson SAS. All rights reserved.
Cardiology Department, CHU Antoine-Béclère, Université Paris Sud, AP-HP, 157, avenue de la Porte-de-Trivaux, 92140 Clamart, France; Inserm UMR-S 769, signalisation et physiopathologie cardiaque, LabEx LERMIT, Châtenay-Malabry, France.
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