Document Detail

Serial echocardiographic observations in patients with primary systemic amyloidosis: an introduction to the concept of early (asymptomatic) amyloid infiltration of the heart.
MedLine Citation:
PMID:  6471919     Owner:  NLM     Status:  MEDLINE    
Echocardiography was used for the serial assessment of 27 patients with primary systemic amyloidosis. Thirteen patients had no clinical cardiac deterioration between the two echocardiographic studies (group 1), whereas in 14 patients (group 2), congestive heart failure or arrhythmias (or both) appeared or worsened during a mean observation period of 19 months. The only echocardiographic changes in group 1 were a mild increase in left ventricular mass and a mild decrease in left ventricular wall systolic thickening. Patients in group 2 had significant changes in left ventricular wall thickness (mean increase, 34%), in left ventricular mass (mean increase, 42%), in right ventricular wall thickness (mean increase, 78%), in left atrial size (mean increase, 19%), in left ventricular mass/voltage ratio (mean increase, 68%), in left ventricular radius/thickness ratio (mean decrease, 29%), and in left ventricular fractional shortening (mean decrease, 13%). Significant correlations were found in group 2 between changes in systolic and diastolic blood pressure and changes in ventricular wall thickness and mass. Changes in left ventricular systolic function did not correlate significantly with changes in other clinical, electrocardiographic, or echocardiographic measurements. In six cases (two in group 1), in which amyloid infiltration of the heart was proved by myocardial biopsy or autopsy, the only echocardiographic abnormality when the patients were asymptomatic was a moderate increase in left or right ventricular wall thickness. We found that M-mode and two-dimensional echocardiographic examinations can substantiate progressive amyloid infiltration of the heart and are useful tools for the noninvasive serial assessment of patients with primary systemic amyloidosis.
L Cueto-Garcia; A J Tajik; R A Kyle; W D Edwards; P R Greipp; J A Callahan; C Shub; J B Seward
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  59     ISSN:  0025-6196     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  1984 Sep 
Date Detail:
Created Date:  1984-10-04     Completed Date:  1984-10-04     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  589-97     Citation Subset:  AIM; IM    
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MeSH Terms
Amyloidosis / complications,  diagnosis*,  pathology,  physiopathology
Blood Pressure
Cardiomyopathies / complications,  diagnosis*,  pathology,  physiopathology
Heart Failure / etiology
Heart Rate
Middle Aged
Stroke Volume

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