Vascular abnormalities in primary amyloidosis.
OBJECTIVE
Primary amyloidosis (AL) is a systemic disease; however, there is limited information regarding the presence and character of vascular abnormalities.


RESULTS
Validated ultrasound techniques were used to prospectively determine carotid artery intimal-medial thickness (IMT) and brachial artery flow-mediated dilatation (FMD) in 59 consecutive AL patients and 17 age-similar, healthy, asymptomatic volunteers (CON). Carotid IMT was increased in AL when compared with CON (0.07 +/- 0.02 vs. 0.04 +/- 0.01 mm, P < 0.01). Similarly, brachial artery FMD was significantly lower in AL when compared with CON subjects (3 +/- 7 vs. 12 +/- 8%, P < 0.01). Multivariable analysis revealed that AL was associated with larger IMT and lower FMD after controlling for several confounding variables. However, within AL cases, there was not a significant association of cardiac vs. non-cardiac involvement with IMT or FMD (P = 0.1 and 0.2, respectively).


CONCLUSIONS
AL is associated with abnormal vascular morphology and endothelial dysfunction. Vascular abnormalities do not appear to be related to echocardiographic evidence of cardiac involvement.
Modesto
Karen M
KM
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
Dispenzieri
Angela
A
Gertz
Morie
M
Cauduro
Sanderson A
SA
Khandheria
Bijoy K
BK
Seward
James B
JB
Kyle
Robert
R
Wood
Christina M
CM
Bailey
Kent R
KR
Tajik
Abdel Jamil
AJ
Miller
Fletcher A
FA
Pellikka
Patricia A
PA
Abraham
Theodore P
TP
D000368:Aged; D000686:Amyloidosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D017539:Tunica Intima / Q000473:pathology; D014463:Ultrasonography; D014652:Vascular Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology