Abnormal stress echocardiography findings in cardiac amyloidosis

Kevin C. Ong, J. Wells Askew, Angela Dispenzieri, Joseph Maleszewski, Kyle W. Klarich, Nandan S. Anavekar, Sharon L. Mulvagh, Martha Grogan

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Cardiac involvement in immunoglobulin light chain (amyloid light chain, AL) amyloidosis is characterized by myocardial interstitial deposition but can also cause obstructive deposits in the coronary microvasculature. Methods: We retrospectively identified 20 patients who underwent stress echocardiography within 1 year prior to the histologic diagnosis of AL amyloidosis. Only patients with cardiac amyloidosis and no known obstructive coronary disease were included. Results: Stress echocardiograms (13 exercise; 7 dobutamine) were performed for evaluation of dyspnea and/or chest pain. Stress-induced wall motion abnormalities (WMAs) occurred in 11 patients (55%), 4 of whom had normal left ventricular wall thickness. Coronary angiogram was performed in 9 of 11 patients and demonstrated no or mild epicardial coronary artery disease. Seven (54%) patients had an abnormal exercise blood pressure which occurred with similar likelihood between those with and without stress-induced WMAs. Conclusions: Stress-induced WMAs and abnormal exercise blood pressure may occur in patients with cardiac AL amyloidosis despite the absence of significant epicardial coronary artery disease. This finding should raise the possibility of cardiac amyloidosis even in the absence of significant myocardial thickening.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalAmyloid
DOIs
StateAccepted/In press - Apr 28 2016

Fingerprint

Stress Echocardiography
Amyloidosis
Amyloid
Exercise
Light
Coronary Artery Disease
Blood Pressure
Immunoglobulin Light Chains
Dobutamine
Microvessels
Chest Pain
Dyspnea
Coronary Disease
Angiography

Keywords

  • AL amyloidosis
  • cardiac amyloidosis
  • echocardiography
  • stress echocardiography

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Abnormal stress echocardiography findings in cardiac amyloidosis. / Ong, Kevin C.; Wells Askew, J.; Dispenzieri, Angela; Maleszewski, Joseph; Klarich, Kyle W.; Anavekar, Nandan S.; Mulvagh, Sharon L.; Grogan, Martha.

In: Amyloid, 28.04.2016, p. 1-8.

Research output: Contribution to journalArticle

Ong, Kevin C. ; Wells Askew, J. ; Dispenzieri, Angela ; Maleszewski, Joseph ; Klarich, Kyle W. ; Anavekar, Nandan S. ; Mulvagh, Sharon L. ; Grogan, Martha. / Abnormal stress echocardiography findings in cardiac amyloidosis. In: Amyloid. 2016 ; pp. 1-8.
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