The value of conventional echocardiographic and tissue doppler imaging in the diagnosis of cardiac amyloidosis

Abstract

Transthoracic echocardiographic characteristics of 17 cases of cardiac amyloidosis (CA), a rare disease in China, were analyzed in order to improve the understanding of the disease. Seventeen cases of biopsy-proven CA, admitted to Wuhan Union Hospital from June 1994 to September 2008 were retrospectively reviewed. Twenty normal volunteers served as control group. Left atrial and ventricular functions and mitral inflow velocity were measured by two-dimensional, and Doppler echocardiography, and tissue Doppler imaging (TDI)-derived peak systolic wall motion velocities (Sv), peak early diastolic wall motion velocities (Ev), and peak late diastolic wall motion (Av) were measured at the septum, lateral, inferior and anterior corners of mitral annulus from the apical 4- and 2 chamber views. Compared with the control group, the interventricular septal thickness (IVSd), the left ventricular posterior wall (LVPWd), right ventricular transverse diameter (RVTDd) near the end of diastole and the interauricular septum thickness (IASs), left atrial anteroposterior diameter (LAADs), right atrial transverse diameter (RATDs) near the end of systole were increased significantly (all P<0.05) and left ventricular ejection fraction (LVEF) decreased (P<0.05) in the CA group. Compared with the control group, Sv, Ev at each wall and Av at almost all walls were significantly decreased in the CA group. In the CA group, Myocardial echoes of interventricular septum and free wall of left ventricle were enhanced evidently and distributed unevenly. The echoes presented as ground glass-like images, with some spotty hyper echoes. Both atria were enlarged, and LVEF decreased, with diastolic function impaired, and mild-moderate hydropericardium found in the CA group. It was concluded that echocardiography was a relatively sensitive and highly specific non-invasive method for the diagnosis of CA.

Research trends and hotspots evolution of cardiac amyloidosis: a bibliometric analysis from 2000 to 2022

“…Studies related to cardiac damage processes such as diastolic function, restrictive cardiomyopathy, and congestive heart failure in amyloidosis have been maintained at a high research fever level [ 14 – 16 ]. Diastolic dysfunction can be observed in CA patients on echocardiography (significant decrease of Ev velocity in all walls of the heart, lateral side < or = − 12 cm/s, medial side < or = − 10 cm/s,) [ 17 , 18 ] In contrast, restrictive cardiomyopathy and hypertrophic cardiomyopathy may be phenotypes of CA, associated with amyloid deposits that infiltrate the myocardial interstitium and “sclerosis” and hypertrophy of the heart [ 19 , 20 ] CA may be an under-recognized cause of heart failure, especially in HFpEF [ 21 ]. A meta-analysis showed that 11% of patients with HFpEF had transthyretin amyloid deposition and were associated with higher age and worse cardiological parameters (NT-proBNP, limb conduction hypovoltage, ventricular wall hypertrophy) [ 22 ].…”

The Evolution and Scope of Cardiac Amyloidosis Research: A Bibliometric Analysis of Echocardiography

“…In addition to the aortic valve, CA can also cause thickening of the mitral and tricuspid valves, leading to varying levels of regurgitation 33,44 . However, these ultrasound features are di cult to diagnose CA due to lack of speci city [45][46][47] .…”