[Electrocardiographic and echocardiographic features of patients with primary cardiac amyloidosis].
OBJECTIVE
To summarize the electrocardiography and echocardiography features of patients with cardiac amyloidosis (CA) diagnosed by endo-myocardial biopsy (EMB).


METHODS
A total of 20 consecutive patients [7 men, mean age (50 ± 12) years] referred for EMB because of clinical suspicion of CA from September 2006 to October 2009 were included in the study. Primary CA was diagnosed in 11 out of 20 patients (55%) by EMB and biomarkers examination. The electrocardiography and echocardiography features were analyzed.


RESULTS
The voltage of all the limb leads were low in the 11 CA patients [mean values of (0.33 - 0.51) mV], the incidence of low voltage and pseudo-infarction patterns were 45% and 45%, respectively. Concentric hypertrophy and normal left ventricular diameters were evidenced in all CA patients on echocardiography, left atrial enlargement (n = 10, 91%), granular/sparking appearance of the myocardium (n = 9, 82%) and moderate to large pericardial effusion (n = 7, 64%) as well as left ventricular systolic dysfunction (n = 8, 73%) were often presented in CA patients.


CONCLUSIONS
The diagnosis of primary CA should be considered in patients with unknown origin of heart failure, concentric hypertrophy and normal left ventricular diameters with granular/sparking appearance of the myocardium or pericardial effusion presented on echocardiography and low voltage of limb leads or pseudo-infarction pattern presented on electrocardiography. EMB and serum (urine) biomarkers examinations should be then performed to confirm or exclude the diagnosis of CA.
Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhong-wei
ZW
Cheng
Zhuang
Z
Tian
Lin
L
Kang
Tai-bo
TB
Chen
Li-gang
LG
Fang
Kang-an
KA
Cheng
Yong
Y
Zeng
Quan
Q
Fang
D000328:Adult; D000686:Amyloidosis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D000075363:Immunoglobulin Light-chain Amyloidosis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies