| 'Hypersynchronisation' by tissue velocity imaging in patients with cardiac amyloidosis. | |
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MedLine Citation:
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PMID: 18474536 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: It is unknown if some patients with cardiac amyloidosis (CA) have mechanical dyssynchrony, as has been demonstrated in patients with ischaemic and dilated cardiomyopathies. The aim of this study was to assess mechanical dyssynchrony in patients with CA using tissue velocity imaging (TVI) and to define its usefulness for risk stratification. DESIGN AND PATIENTS: We included 121 patients with primary amyloidosis and 37 age-matched and sex-matched controls. Patients were divided into two groups: 60 with advanced-CA and 61 with no-advanced-CA, according to left ventricular (LV) wall thickness and diastolic dysfunction. Dyssynchrony assessment included: (1) atrioventricular dyssynchrony (dys), (2) interventricular dys, (3) intraventricular dys assessed longitudinally, using the standard deviation of time to systolic peak velocity (Ts-SD) of the 12 basal and mid level LV segments, and (4) intraventricular dys assessed radially, using the difference in radial Ts between mid anteroseptal and mid posterior segments. OUTCOME: Primary end-point was all-cause death. During a median follow-up of 13 months there were 35 events among patients. RESULTS: Contrary to the hypothesis, the intraventricular dys indices in advanced-CA patients were reduced compared to either the no-advanced-CA group or to controls (Ts-SD: 12.1 (9.0); 35.1 (18.6); 24.5 (14.1), respectively, p<0.001). This reduction was primarily the result of decreased ejection time (ET). Moreover, ET was the most significant predictor of survival (HR = 0.98, p<0.001). CONCLUSIONS: The regional timing of systolic motion measured by TVI was abnormally synchronised in the patients with advanced-CA. ET reduction plays a prominent part in this process and should be considered an essential parameter for assessment of patients with cardiac amyloidosis. |
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Authors:
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D Bellavia; P A Pellikka; T P Abraham; G B Al-Zahrani; A Dispenzieri; J K Oh; R E Espinosa; C G Scott; C Miyazaki; F A Miller |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-05-12 |
Journal Detail:
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Title: Heart (British Cardiac Society) Volume: 95 ISSN: 1468-201X ISO Abbreviation: Heart Publication Date: 2009 Mar |
Date Detail:
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Created Date: 2009-01-15 Completed Date: 2009-04-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9602087 Medline TA: Heart Country: England |
Other Details:
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Languages: eng Pagination: 234-40 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Amyloidosis
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physiopathology*,
ultrasonography Atrioventricular Node / physiopathology*, ultrasonography Biological Markers / metabolism Blood Pressure / physiology Bundle-Branch Block / physiopathology Case-Control Studies Echocardiography, Doppler Female Heart Failure, Systolic / physiopathology*, ultrasonography Humans Male Middle Aged Myocardial Contraction / physiology Prognosis Severity of Illness Index Stroke Volume / physiology* Ventricular Function, Left / physiology* |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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