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Echocardiographic Patterns of Left Ventricular Diastolic Function in Cardiac Amyloidosis: An Updated Evaluation

Silvia Oghina1,2,3,4, Wulfran Bougouin5,6, Mounira Kharoubi1,2,3,4,7

  • 1French Referral Centre for Cardiac Amyloidosis, Henri Mondor Teaching Hospital, APHP, 1, Rue Gustave Eiffel, 94010 Creteil, France.

Journal of Clinical Medicine
|November 13, 2021
PubMed

Insights

Cardiac amyloidosis (CA) diagnosis is often late, impacting prognosis. This study reveals varied left ventricular diastolic function (LVDF) patterns in CA, with earlier stages showing better outcomes.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Cardiac Physiology

Background:

  • Cardiac amyloidosis (CA) is increasingly recognized as a treatable cause of heart failure with preserved ejection fraction.
  • Late diagnosis of CA contributes to a poor prognosis despite available treatments.
  • Understanding left ventricular diastolic function (LVDF) patterns is crucial for timely CA diagnosis and management.

Purpose of the Study:

  • To characterize LVDF patterns in a large contemporary cohort of cardiac amyloidosis patients.
  • To identify clinical, laboratory, and echocardiographic determinants of these LVDF patterns.
  • To assess the prognostic implications of different LVDF patterns in CA.

Main Methods:

  • Observational study of 464 patients with confirmed CA from a tertiary referral center.
  • Standard echocardiography was used to analyze LVDF.
  • Clinical, laboratory, and survival data were collected and analyzed.

Main Results:

  • 41% of patients had grade III (restrictive) LVDF, 25% grade II, and 25% grade I; 9% were unclassified.
  • LVDF grades II and III were independently associated with dyspnea, elevated NT-proBNP, cardiac infiltration, and global longitudinal strain.
  • Patients with grade I LVDF demonstrated a better prognosis.

Conclusions:

  • All grades of LVDF can be present in cardiac amyloidosis.
  • A significant proportion of CA patients (25%) exhibit grade I LVDF, indicating earlier disease phenotypes.
  • Early identification of LVDF patterns in CA is associated with a better prognosis, highlighting the need for improved diagnostic strategies.
Abstract

Keywords:
cardiac amyloidosisdiastolic functionechocardiographyguidelinesheart failure

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