Cited 37 times since 2007 (2.2 per year) source: EuropePMC European journal of heart failure, Volume 9, Issue 8, 22 4 2007, Pages 808-813 Importance of the echocardiographic evaluation of right ventricular function in patients with AL amyloidosis. Ghio S, Perlini S, Palladini G, Marsan NA, Faggiano G, Vezzoli M, Klersy C, Campana C, Merlini G, Tavazzi L
Background
Patients with AL amyloidosis often present with signs of congestive heart failure.
Aim
This study was prospectively designed to assess the significance of RV dysfunction in AL amyloidosis.
Methods and results
Seventy-four patients with biopsy proven AL amyloidosis underwent a thorough echocardiographic evaluation. A tricuspid annular plane systolic excursion (TAPSE)<17 mm was taken as marker of RV dysfunction. Plasma NT-proBNP determinations were performed in all cases. RV function was normal in 60 patients and reduced in 14 patients. Patients with RV dysfunction had thicker left ventricular (LV) walls (p<0.01), lower LV end-diastolic volumes (p<0.01), lower LV ejection fraction (p<0.01) and more frequently a restrictive LV filling pattern (p<0.01). RV dimensions and RV free wall thickness were not significantly different in the two groups. A thick interventricular septum and a reduced TAPSE were associated with high NT-proBNP levels (both p<0.01). Seven patients died during a median follow-up period of 19 months; TAPSE<17 mm was the only echocardiographic parameter associated with poor survival.
Conclusion
In patients with AL amyloidosis, RV dysfunction is associated with more severe involvement of the left ventricle, higher plasma levels of NT-proBNP and with poor prognosis.
