TY - JOUR
T1 - Vascular abnormalities in primary amyloidosis
AU - Modesto, Karen M.
AU - Dispenzieri, Angela
AU - Gertz, Morie
AU - Cauduro, Sanderson A.
AU - Khandheria, Bijoy K.
AU - Seward, James B.
AU - Kyle, Robert
AU - Wood, Christina M.
AU - Bailey, Kent R.
AU - Tajik, Abdel Jamil
AU - Miller, Fletcher A.
AU - Pellikka, Patricia A.
AU - Abraham, Theodore P.
PY - 2007/4
Y1 - 2007/4
N2 - Aims: Primary amyloidosis (AL) is a systemic disease; however, there is limited information regarding the presence and character of vascular abnormalities. Methods and results: Validated ultrasound techniques were used to prospectively determine carotid artery intimal-medial thickness (IMT) and brachial artery flow-mediated dilatation (FMD) in 59 consecutive AL patients and 17 age-similar, healthy, asymptomatic volunteers (CON). Carotid IMT was increased in AL when compared with CON (0.07 ± 0.02 vs. 0.04 ± 0.01 mm, P < 0.01). Similarly, brachial artery FMD was significantly lower in AL when compared with CON subjects (3 ± 7 vs. 12 ± 8%, P < 0.01). Multivariable analysis revealed that AL was associated with larger IMT and lower FMD after controlling for several confounding variables. However, within AL cases, there was not a significant association of cardiac vs. non-cardiac involvement with IMT or FMD (P = 0.1 and 0.2, respectively). Conclusion: AL is associated with abnormal vascular morphology and endothelial dysfunction. Vascular abnormalities do not appear to be related to echocardiographic evidence of cardiac involvement.
AB - Aims: Primary amyloidosis (AL) is a systemic disease; however, there is limited information regarding the presence and character of vascular abnormalities. Methods and results: Validated ultrasound techniques were used to prospectively determine carotid artery intimal-medial thickness (IMT) and brachial artery flow-mediated dilatation (FMD) in 59 consecutive AL patients and 17 age-similar, healthy, asymptomatic volunteers (CON). Carotid IMT was increased in AL when compared with CON (0.07 ± 0.02 vs. 0.04 ± 0.01 mm, P < 0.01). Similarly, brachial artery FMD was significantly lower in AL when compared with CON subjects (3 ± 7 vs. 12 ± 8%, P < 0.01). Multivariable analysis revealed that AL was associated with larger IMT and lower FMD after controlling for several confounding variables. However, within AL cases, there was not a significant association of cardiac vs. non-cardiac involvement with IMT or FMD (P = 0.1 and 0.2, respectively). Conclusion: AL is associated with abnormal vascular morphology and endothelial dysfunction. Vascular abnormalities do not appear to be related to echocardiographic evidence of cardiac involvement.
KW - Amyloidosis
KW - Endothelial function
KW - Flow-mediated arterial dilatation
KW - Intimal-medial thickness
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U2 - 10.1093/eurheartj/ehm066
DO - 10.1093/eurheartj/ehm066
M3 - Article
C2 - 17430997
AN - SCOPUS:34548308828
SN - 0195-668X
VL - 28
SP - 1019
EP - 1024
JO - European heart journal
JF - European heart journal
IS - 8
ER -