| Evaluation and management of the cardiac amyloidosis. | |
| | |
MedLine Citation:
|
PMID: 18036445 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Cardiac amyloidosis describes clinically significant involvement of the heart by amyloid deposition, which may or may not be associated with involvement of other organs. The purpose of this review is to summarize the current state of evidence for the effective evaluation and management of cardiac amyloidosis. Acquired systemic amyloidosis occurs in more than 10 per million person-years in the U.S. population. Although no single noninvasive test or abnormality is pathognomonic of cardiac amyloid, case-control studies indicate that echocardiographic evidence of left ventricular wall thickening, biatrial enlargement, and increased echogenicity in conjunction with reduced electrocardiographic voltages is strongly suggestive of cardiac amyloidosis. Furthermore, newer echocardiographic techniques such as strain and strain rate imaging can demonstrate impairment in longitudinal function before ejection fraction becomes abnormal. Recent observational studies also suggest that cardiovascular magnetic resonance imaging yields characteristic findings in amyloidosis, offering promise for the early detection of cardiac involvement, and the presence of detectable cardiac troponin and elevated B-type natriuretic peptide in serum of affected patients portends an adverse prognosis. Management strategies for cardiac amyloid are largely based on nonrandomized single-center studies. One of the few published randomized studies shows the superiority of oral prednisolone and melphalan compared with colchicine in systemic AL amyloidosis. Intermediate-dose infusional chemotherapy regimes (such as vincristine, adriamycin, and dexamethasone) and high-dose chemotherapy with peripheral stem cell rescue have been used widely, but treatment-related mortality remains substantial with chemotherapy. Recent studies also indicate promising strategies to stabilize the native structures of amyloidogenic proteins; inhibit fibril formation; and disrupt established deposits using antibodies, synthetic peptides, and small-molecule drugs. |
| | |
Authors:
|
Joseph B Selvanayagam; Philip N Hawkins; Biju Paul; Saul G Myerson; Stefan Neubauer |
Related Documents
:
|
8281545 - Acute myocardial infarction and left ventricular aneurysm in a patient with normal coro... 22415145 - Cardioprotection through s-nitros(yl)ation of macrophagemigration inhibitory factor. 19943435 - Successful use of extracorporeal membrane oxygenation and drotrecogin alpha in patients... 7260965 - Cardiac involvement in secondary haemochromatosis: a catheter biopsy study and analysis... 22863175 - Usefulness of hyponatremia in the acute phase of st-elevation myocardial infarction as ... 8961075 - Role of endothelin in a rabbit model of acute myocardial infarction: effects of recepto... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't; Review Date: 2007-11-13 |
Journal Detail:
|
Title: Journal of the American College of Cardiology Volume: 50 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2007 Nov |
Date Detail:
|
Created Date: 2007-11-26 Completed Date: 2008-01-07 Revised Date: 2011-05-10 |
Medline Journal Info:
|
Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 2101-10 Citation Subset: AIM; IM |
Affiliation:
|
Department of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom. joseph.selva@fmc.sa.gov.au |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Amyloid
/
blood Amyloidosis / blood, diagnosis*, drug therapy* Antineoplastic Agents / therapeutic use* Biological Markers / blood Electrocardiography Heart Diseases / blood, diagnosis*, drug therapy* Humans Magnetic Resonance Imaging Troponin / blood Ultrasonography |
| Chemical | |
Reg. No./Substance:
|
0/Amyloid; 0/Antineoplastic Agents; 0/Biological Markers; 0/Troponin |
| Comments/Corrections | |
Comment In:
|
J Am Coll Cardiol. 2008 Apr 15;51(15):1509-10; author reply 1510
[PMID:
18402909
]
|
Erratum In:
|
J Am Coll Cardiol. 2011 Mar 29;57(13):1501 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Anti-myeloma activity of endogenous and adoptively transferred activated natural killer cells in exp...
Next Document: Gender-specific outcomes after sirolimus-eluting stent implantation.