Doppler characterization of left ventricular diastolic function in cardiac amyloidosis
AL Klein,
LK Hatle,
DJ Burstow,
JB Seward,
RA Kyle,
KR Bailey,
TF Luscher,
MA Gertz,
and
AJ Tajik
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
Sixty-four patients with primary systemic amyloidosis-53 with two-dimensional echocardiographic features of cardiac involvement (Group I) and 11 without cardiac involvement (Group II)--underwent Doppler echocardiographic assessment of left ventricular diastolic function. Pulsed wave Doppler recordings of left ventricular inflow velocities and pulmonary vein flow velocities with respiratory monitoring in these patients were compared with findings in a normal group. Patients in Group I showed striking abnormalities of left ventricular diastolic filling when classified into subgroups by mean left ventricular wall thickness: early greater than 12 but less than 15 mm; advanced greater than or equal to 15 mm. In early amyloidosis, relaxation was abnormal, with decreased peak early velocity (75 +/- 20 versus 86 +/- 16 cm/s; p less than 0.01), increased late velocity (71 +/- 22 versus 56 +/- 13 cm/s; p less than 0.01), decreased early to late velocity ratio (1.2 +/- 0.6 versus 1.6 +/- 0.5; p less than 0.01) and prolonged isovolumic relaxation time (87 +/- 15 versus 73 +/- 13 ms; p less than 0.01) compared with normal values. In advanced amyloidosis, there was a restrictive filling pattern with a markedly shortened deceleration time (148 +/- 50 versus 199 +/- 32 ms; p less than 0.001), decreased pulmonary vein peak systolic flow velocity (34 +/- 16 versus 54 +/- 12 cm/s; p less than 0.01) and increased diastolic flow velocity (55 +/- 20 versus 44 +/- 12 cm/s; p less than 0.01) compared with normal values. Group and the subgroup with early amyloidosis had similar flow velocity patterns. Thus, this study documents that in cardiac amyloidosis, a spectrum of diastolic filling abnormalities exists; the restrictive filling pattern is seen only in the advanced stages.
This article has been cited by other articles:
|
|
|
|
 
H. Vogelsberg, H. Mahrholdt, C. C. Deluigi, A. Yilmaz, E. M. Kispert, S. Greulich, K. Klingel, R. Kandolf, and U. Sechtem
Cardiovascular magnetic resonance in clinically suspected cardiac amyloidosis: noninvasive imaging compared to endomyocardial biopsy.
J. Am. Coll. Cardiol.,
March 11, 2008;
51(10):
1022 - 1030.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Feng, W. D. Edwards, J. K. Oh, K. Chandrasekaran, M. Grogan, M. W. Martinez, I. I. Syed, D. A. Hughes, J. A. Lust, A. S. Jaffe, et al.
Intracardiac Thrombosis and Embolism in Patients With Cardiac Amyloidosis
Circulation,
November 20, 2007;
116(21):
2420 - 2426.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H J Lachmann and P N Hawkins
Amyloidosis and the lung
Chronic Respiratory Disease,
November 1, 2006;
3(4):
203 - 214.
[Abstract]
[PDF]
|
|
|
|
|
|
|
K. B. Shah, Y. Inoue, and M. R. Mehra
Amyloidosis and the heart: a comprehensive review.
Arch Intern Med,
September 25, 2006;
166(17):
1805 - 1813.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Lindqvist, B.O. Olofsson, C. Backman, O. Suhr, and A. Waldenstrom
Pulsed tissue Doppler and strain imaging discloses early signs of infiltrative cardiac disease: A study on patients with familial amyloidotic polyneuropathy
Eur J Echocardiogr,
January 1, 2006;
7(1):
22 - 30.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. H. Falk
Diagnosis and Management of the Cardiac Amyloidoses
Circulation,
September 27, 2005;
112(13):
2047 - 2060.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. M. Maceira, J. Joshi, S. K. Prasad, J. C. Moon, E. Perugini, I. Harding, M. N. Sheppard, P. A. Poole-Wilson, P. N. Hawkins, and D. J. Pennell
Cardiovascular Magnetic Resonance in Cardiac Amyloidosis
Circulation,
January 18, 2005;
111(2):
186 - 193.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Palecek, A. Linhart, J. Bultas, and M. Aschermann
Comparison of early diastolic mitral annular velocity and flow propagation velocity in detection of mild to moderate left ventricular diastolic dysfunction
Eur J Echocardiogr,
June 1, 2004;
5(3):
196 - 204.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Koyama, P. A. Ray-Sequin, and R. H. Falk
Longitudinal Myocardial Function Assessed by Tissue Velocity, Strain, and Strain Rate Tissue Doppler Echocardiography in Patients With AL (Primary) Cardiac Amyloidosis
Circulation,
May 20, 2003;
107(19):
2446 - 2452.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Tabata, J. D. Thomas, and A. L. Klein
Pulmonary venous flow by doppler echocardiography: revisited 12 years later
J. Am. Coll. Cardiol.,
April 16, 2003;
41(8):
1243 - 1250.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Koyama, P. A. Ray-Sequin, and R. H. Falk
Prognostic Significance of Ultrasound Myocardial Tissue Characterization in Patients With Cardiac Amyloidosis
Circulation,
July 30, 2002;
106(5):
556 - 561.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Diez, R. Querejeta, B. Lopez, A. Gonzalez, M. Larman, and J. L. Martinez Ubago
Losartan-Dependent Regression of Myocardial Fibrosis Is Associated With Reduction of Left Ventricular Chamber Stiffness in Hypertensive Patients
Circulation,
May 28, 2002;
105(21):
2512 - 2517.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Dingli, J. P. Utz, and M. A. Gertz
Pulmonary Hypertension in Patients With Amyloidosis
Chest,
November 1, 2001;
120(5):
1735 - 1739.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Liao, M. Jain, P. Teller, L. H. Connors, S. Ngoy, M. Skinner, R. H. Falk, and C. S. Apstein
Infusion of Light Chains From Patients With Cardiac Amyloidosis Causes Diastolic Dysfunction in Isolated Mouse Hearts
Circulation,
October 2, 2001;
104(14):
1594 - 1597.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Dispenzieri, M. Q. Lacy, R. A. Kyle, T. M. Therneau, D. R. Larson, S. V. Rajkumar, R. Fonseca, P. R. Greipp, T. E. Witzig, J. A. Lust, et al.
Eligibility for Hematopoietic Stem-Cell Transplantation for Primary Systemic Amyloidosis Is a Favorable Prognostic Factor for Survival
J. Clin. Oncol.,
July 15, 2001;
19(14):
3350 - 3356.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J Meluzin, L Spinarova, J Bakala, J Toman, J Krejci, P Hude, T Kara, and M Soucek
Pulsed Doppler tissue imaging of the velocity of tricuspid annular systolic motion. A new, rapid, and non-invasive method of evaluating right ventricular systolic function
Eur. Heart J.,
February 2, 2001;
22(4):
340 - 348.
[Abstract]
[PDF]
|
|
|
|
|
|
|
A. Bollmann, K.-H. Binias, F. Grothues, K. Sonne, H.-D. Esperer, P. Nikutta, and H. U. Klein
Left Atrial Appendage Flow in Nonrheumatic Atrial Fibrillation : Relationship With Pulmonary Venous Flow and ECG Fibrillatory Wave Amplitude
Chest,
February 1, 2001;
119(2):
485 - 492.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. J. Garcia, M. S. Firstenberg, N. L. Greenberg, N. Smedira, L. Rodriguez, D. Prior, and J. D. Thomas
Estimation of left ventricular operating stiffness from Doppler early filling deceleration time in humans
Am J Physiol Heart Circ Physiol,
February 1, 2001;
280(2):
H554 - H561.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T.-H. Chao, L.-M. Tsai, W.-C. Tsai, Y.-H. Li, L.-J. Lin, and J.-H. Chen
Effect of Atrial Fibrillation on Pulmonary Venous Flow Patterns Assessed by Doppler Transesophageal Echocardiography
Chest,
June 1, 2000;
117(6):
1546 - 1550.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. G. DiSalvo, M. E. King, and R. N. Smith
Case 3-2000- A 66-Year-Old Woman with Diabetes, Coronary Disease, Orthostatic Hypotension, and the Nephrotic Syndrome
N. Engl. J. Med.,
January 27, 2000;
342(4):
264 - 273.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. J. Garcia, N. G. Smedira, N. L. Greenberg, M. Main, M. S. Firstenberg, J. Odabashian, and J. D. Thomas
Color M-mode Doppler flow propagation velocity is a preload insensitive index of left ventricular relaxation: animal and human validation
J. Am. Coll. Cardiol.,
January 1, 2000;
35(1):
201 - 208.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. N. DeMaria and D. Blanchard
The hemodynamic basis of diastology
J. Am. Coll. Cardiol.,
November 15, 1999;
34(6):
1659 - 1662.
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Gonzalez-Vilchez, M. Ares, J. Ayuela, and L. Alonso
Combined use of pulsed and color M-mode doppler echocardiography for the estimation of pulmonary capillary wedge pressure: an empirical approach based on an analytical relation
J. Am. Coll. Cardiol.,
August 1, 1999;
34(2):
515 - 523.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. B. Solomon, P. Barbier, and S. A. Glantz
Changes in porcine transmitral flow velocity pattern and its diastolic determinants during partial coronary occlusion
J. Am. Coll. Cardiol.,
March 1, 1999;
33(3):
854 - 866.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. J. Garcia, J. D. Thomas, and A. L. Klein
New Doppler echocardiographic applications for the study of diastolic function
J. Am. Coll. Cardiol.,
October 1, 1998;
32(4):
865 - 875.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B Longo-Mbenza, L V Seghers, E K. Vita, K Tonduangu, and M Bayekula
Assessment of ventricular diastolic function in AIDS patients from Congo: a Doppler echocardiographic study
Heart,
August 1, 1998;
80(2):
184 - 189.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
R. H. Falk, R. L. Comenzo, and M. Skinner
The Systemic Amyloidoses
N. Engl. J. Med.,
September 25, 1997;
337(13):
898 - 909.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. D. Cheitlin, J. S. Alpert, W. F. Armstrong, G. P. Aurigemma, G. A. Beller, F. Z. Bierman, T. W. Davidson, J. L. Davis, P. S. Douglas, L. D. Gillam, et al.
ACC/AHA Guidelines for the Clinical Application of Echocardiography : A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee on Clinical Application of Echocardiography) Developed in Collaboration With the American Society of Echocardiography
Circulation,
March 18, 1997;
95(6):
1686 - 1744.
[Full Text]
|
|
|
|
|
|
|
G. F. Mureddu, G. de Simone, R. Greco, G. F. Rosato, and F. Contaldo
Left Ventricular Filling in Arterial Hypertension: Influence of Obesity and Hemodynamic and Structural Confounders
Hypertension,
February 1, 1997;
29(2):
544 - 550.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
S. Schafer, C. Schardt, U. Burkhard-Meier, R. M. Klein, M. P. Heintzen, and B. E. Strauer
Angina Pectoris and Progressive Fatigue in a 61-Year-Old Man
Circulation,
December 15, 1996;
94(12):
3376 - 3381.
[Full Text]
|
|
|
|
|
|
|
R. Belardinelli, D. Georgiou, G. Cianci, N. Berman, L. Ginzton, and A. Purcaro
Exercise Training Improves Left Ventricular Diastolic Filling in Patients With Dilated Cardiomyopathy : Clinical and Prognostic Implications
Circulation,
June 1, 1995;
91(11):
2775 - 2784.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
S. E. Litwin, S. E. Katz, E. O. Weinberg, B. H. Lorell, G. P. Aurigemma, and P. S. Douglas
Serial Echocardiographic-Doppler Assessment of Left Ventricular Geometry and Function in Rats With Pressure-Overload Hypertrophy : Chronic Angiotensin-Converting Enzyme Inhibition Attenuates the Transition to Heart Failure
Circulation,
May 15, 1995;
91(10):
2642 - 2654.
[Abstract]
[Full Text]
|
|
|
|
