title: Prevalence and prognostic value of conduction disturbances at the time of diagnosis of cardiac AL amyloidosis.
abstract: OBJECTIVE
  To evaluate the prevalence and the prognostic implications of conduction delays in a large cohort of cardiac AL patients.
  
  
  METHODS
  Echo Doppler and 12-lead ECG were collected in 344 consecutive patients in whom diagnosis of AL amyloidosis was concluded between 2008 and 2010. Patients were subdivided according to the presence (n = 240) or absence (n = 104) of cardiac involvement.
  
  
  RESULTS
  When compared with patients without myocardial involvement, cardiac AL was associated with prolonged PQ, QRS, QT and QTc intervals (P < 0.05), and with higher prevalence of intraventricular blocks (27.5% vs. 16.5%, P < 0.05), that was associated with higher wall thickness, worse diastolic and regional systolic function, higher NT-proBNP values (all P < 0.05), and higher mortality (P = 0.0001; median follow-up: 402 days).
  
  
  CONCLUSIONS
  Intraventricular conduction delays have a negative prognostic impact in patients with cardiac AL amyloidosis. Their presence should not be overlooked in the diagnostic workup, prompting a more accurate cardiological support.
authors.affiliation: Clinica Medica II Department of Internal Medicine, Fondazione IRCCS San Matteo, University of Pavia, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Boldrini
authors.forename: Francesco
authors.initials: F
authors.lastname: Salinaro
authors.forename: Roberta
authors.initials: R
authors.lastname: Mussinelli
authors.forename: Ambra
authors.initials: A
authors.lastname: Raimondi
authors.forename: Alessio
authors.initials: A
authors.lastname: Alogna
authors.forename: Francesco
authors.initials: F
authors.lastname: Musca
authors.forename: Giovanni
authors.initials: G
authors.lastname: Palladini
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Merlini
authors.forename: Stefano
authors.initials: S
authors.lastname: Perlini
mesh_terms: D017677:Age Distribution; D000368:Aged; D000686:Amyloidosis / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D000704:Analysis of Variance; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000453:epidemiology*; D015415:Biomarkers / Q000032:analysis; D053840:Brugada Syndrome; D000075224:Cardiac Conduction System Disease; D009202:Cardiomyopathies / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015331:Cohort Studies; D015150:Echocardiography, Doppler / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006329:Heart Conduction System / Q000002:abnormalities*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000032:analysis; D010446:Peptide Fragments / Q000032:analysis; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: amyloid; conduction disturbances; echocardiography; electrocardiography; prognosis