Copyright © 1992 by the European Society of Cardiology.
© 1992 The European Society of Cardiology
Amyloid cardiomyopathy in systemic non-hereditary amyloidosis. Clinical, echocardiographic and electrocardiographic findings in 30 patients with AA and 24 patients with AL amyloidosis
*Departments of Cardiology and Rheumatology Groningen, The Netherlands
Departments of University Hospital Groningen Groningen, The Netherlands
Received 7 December 1990; revised 20 May 1991; .
Correspondence. J. P M. Hamer, MD, Thoraxcentre, Dept of Cardiology, University Hospital Groningen, 59 Oostersingel, 9713 EZ Groningen, The Netherlands.
Abstract
To underline the role of echocardiography in the detection of cardiac involvement in patients with amyloidosis, physical examination, echocardiography and electrocardiography were performed in 30 patients with AA amyloidosis (amyloid protein A, associated with chronic inflammatory disease, usually without cardiomyopathy) and 24 patients with AL amyloidosis (the immunoglobulin light chain derived type, often associated with cardiomyopathy). All patients had histological confirmation of amyloidosis by rectal or subcutaneous abdominal fat biopsy.
The combination of increased thickness of the left ventricular posterior wall and interventricular septum with a low voltage electrocardiographic pattern is highly specific for cardiac amyloidosis and was found in 3/30 (10%) of the A A patients and in 13/24 (54%) of the AL patients.
The echocardiographic abnormalities were strongly related to the degree of clinical heart disease, showing mildly or moderately increased wall thickness in the early asymptomatic phase or severe thickening and hypokinesia of the left ventricular posterior wall and interventricular septum in clinically apparent cardiac dysfunction.
Echocardiography appears to be a sensitive test for the detection of cardiac involvement in amyloidosis, in symptomatic as well as asymptomatic patients.
Key Words: Amyloidosis • cardiomyopathy • echocardiography
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