ECHOCARDIOGRAPHIC FINDINGS IN SYSTEMIC AMYLOIDOSIS - SPECTRUM OF CARDIAC INVOLVEMENT AND RELATION TO SURVIVAL
ECHOCARDIOGRAPHIC FINDINGS IN SYSTEMIC AMYLOIDOSIS - SPECTRUM OF CARDIAC INVOLVEMENT AND RELATION TO SURVIVAL
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DOI：
10.1016/s0735-1097(85)80475-7
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发表时间：
1985-01-01
影响因子：
24
通讯作者：
TAJIK, AJ
中科院分区：
文献类型：
--
作者：
CUETOGARCIA, L;REEDER, GS;TAJIK, AJ
132例经活检证实的系统性淀粉样变性患者接受超声心动图检查以确定心脏受累范围。超声心动图异常与随访时的临床变量和生存率相关。患者按左心室壁厚度进行亚组：第I组，平均壁厚度≤ 12 mm;第II组，平均壁厚度大于12 mm但小于15 mm;第III组，平均壁厚度≥ 15 mm;或第IV组，非典型特征，如室壁运动异常或左心室扩张。室壁厚度越大的患者，超声心动图相关异常的频率越高，如左心房扩大或二维检查中出现颗粒状闪烁，更常见的是收缩功能降低。临床充血性心力衰竭的发生与更大的室壁厚度和多种其他超声心动图异常密切相关。壁厚增加和收缩功能下降对生存率有负面影响。整个组的中位生存期为1.1年。超声心动图检查是确定心脏淀粉样蛋白受累的重要工具，并可能有助于估计此类患者的预后。
One hundred thirty-two patients with biopsy-proven systemic amyloidosis underwent echocardiographic examination to define the spectrum of cardiac involvement. Echocardiographic abnormalities were then correlated with clinical variables and survival at follow-up. Patients were subgrouped by left ventricular wall thickness: Group I, mean wall thickness 12 mm or less; Group II, mean wall thickness greater than 12 mm but less than 15 mm; Group III, mean wall thickness 15 mm or greater; or Group IV, atypical features such as wall motion abnormalities or left ventricular dilation. Patients with greater wall thickness had a higher frequency of associated echocardiographic abnormalities such as left atrial enlarge ment or granular sparkling appearance on two-dimensional examination and, more commonly, reduced systolic function. The occurrence of clinical congestive heart failure was strongly correlated with greater wall thickness and multiple other echocardiographic abnormalities. Survival was negatively influenced both by greater wall thickness and reduced systolic function. The median survival of the entire group was 1.1 years. Echocardiographic examination is an important tool for establishing the presence of cardiac amyloid involvement and may be useful in estimating prognosis in such patients.