Doppler assessment of diastolic function in cardiac amyloidosis.
The hallmark of cardiac amyloidosis is abnormal diastolic function secondary to amyloid infiltration of the ventricular walls, which accounts for the term "stiff heart syndrome."  The abnormal diastolic function has not yet been well characterized, however.  Thus, we assessed left and right ventricular diastolic function in 53 patients with cardiac amyloidosis.  We measured the left and right ventricular inflow and venous flow velocities with Doppler echocardiography and found a range of Doppler filling abnormalities.  These abnormalities were dependent on the degree of amyloid infiltration of the heart as measured by mean left ventricular wall thickness.  Patients with advanced cardiac amyloidosis (a wall thickness greater than or equal to 15 mm) showed restriction, while patients with early cardiac amyloidosis (a wall thickness less than 15 mm) showed abnormal relaxation or normal filling.  In another study, during a 13-month follow-up, patients with early cardiac amyloidosis showed Doppler patterns that evolved from abnormal relaxation through a normal stage, to an advanced stage of restrictive disease.  We also have demonstrated the importance of left ventricular inflow variables in predicting the outcome of patients with cardiac amyloidosis.  We concluded that Doppler echocardiography is useful in characterizing abnormal diastolic function in patients with cardiac amyloidosis.
Department of Cardiology, The Cleveland Clinic Foundation, OH 44106.
A L
AL
Klein
A J
AJ
Tajik
D000686:Amyloidosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001783:Blood Flow Velocity; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D011379:Prognosis; D016276:Ventricular Function / Q000502:physiology*