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Clinical characteristics and cardiac imaging features of patients with cardiac amyloidosis / 中华心血管病杂志
Chinese Journal of Cardiology ; (12): 960-964, 2015.
Article in Chinese | WPRIM | ID: wpr-317632
ABSTRACT
<p><b>OBJECTIVE</b>To summarize the clinical characteristics and cardiac imaging features by focusing the diagnostic value of MRI in patients with cardiac amyloidosis (CA).</p><p><b>METHODS</b>A total of 31 cases with pathologically proven CA from January 2013 to December 2014 were included in this retrospective study.</p><p><b>RESULTS</b>Patients expressed typical disease manifestations at a late age (54±11) years. Majority patients were male (20 cases, 64.5%) in this cohort. Blood pressure was normal, 13 cases (42.9%) presented with edema in lower limbs, 12 cases (38.7%) with chest distress and dyspnea and 9 cases (29.0%) with abdominal pain and diarrhea. Electrocardiogram (ECG) features were as follows 20 cases (64.5%) with low voltage in limb leads, 20 cases (64.5%) with poor R-wave progression in precordial leads, 17 cases (54.8%) with pseudo-necrotic Q wave and 27 cases (87.1%) with ST-T changes. Echocardiography examination showed that 25 (80.6%) of 31 cases were with left atrial enlargement, 22 cases (71%) with increased ventricular septal thickness and 12 cases (38.7%) with myocardial ground-glass opacity, 24 cases (77.4%) presented restrictive left ventricular filling pattern, 14 cases (45.2%) showed impaired left ventricular systolic function and 10 cases (32.3%) expressed abnormal left ventricular eject function (<50%). Cardiac MRI features were as follows among 31 patients, 7 patients underwent cardiac MRI. Left ventricular and interventricular septum hypertrophy were vsulized in 6 cases, increased thickness of interatrial spetum in 3 cases, left atrial enlargement in 4 cases and right atrial enlargement in 3 cases. MRI also revealed a distinct diffuse delayed gadolinium enhancement of subendocardial and interventricular septum in 3 cases, 1 of which was with delayed enhancement of interatrial spetum.</p><p><b>CONCLUSIONS</b>Clinically, CA diagnosis should be considered for patients with manifestations of chest distress and edema in lower limbs, ECG features of low voltage in limb leads, poor R-wave progression and pseudo-necrotic Q wave, myocardial hypertrophy with myocardial ground-glass opacity in echocardiography and a characteristic MRI pattern of diffuse subendocardial delayed gadolinium enhancement even without the pathological proof.</p>
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Full text: Available Index: WPRIM (Western Pacific) Main subject: Systole / Magnetic Resonance Imaging / Echocardiography / Retrospective Studies / Electrocardiography / Ventricular Septum / Gadolinium / Heart Diseases / Heart Ventricles / Amyloidosis Type of study: Observational study Limits: Female / Humans / Male Language: Chinese Journal: Chinese Journal of Cardiology Year: 2015 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Systole / Magnetic Resonance Imaging / Echocardiography / Retrospective Studies / Electrocardiography / Ventricular Septum / Gadolinium / Heart Diseases / Heart Ventricles / Amyloidosis Type of study: Observational study Limits: Female / Humans / Male Language: Chinese Journal: Chinese Journal of Cardiology Year: 2015 Type: Article