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Circulation, Vol 63, 188-196, Copyright © 1981 by American Heart Association
AG Siqueira-Filho, CL Cunha, AJ Tajik, JB Seward, TT Schattenberg and ER Giuliani
Twenty-eight patients with cardiac amyloidosis were studied by
echocardiography -- 26 by M-mode and 13 by two-dimensional (2D) studies.
All had heart failure and biopsy-proved amyloidosis, M-mode features
included (1) normal left ventricular (LV) dimension in all; (2) thickened
ventricular septum (88%), LV posterior wall (77%), and right ventricular
(RV) anterior wall (79%); (3) decreased thickening of ventricular septum
(96%) and of LV posterior wall (65%) and reduced LV global function (62%);
(4) left atrial enlargement (50%); and (5) pericardial effusion (58%).
Two-dimensional echocardiography provided additional features: (1)
thickened papillary muscles (five of 13); (2) thickened valves (four of
13); (3) better appreciation of thickened RV wall; and (4) a characteristic
"granular sparkling" appearance of thickened cardiac walls -- presumably
secondary to the amyloid deposit - - which was noted in 12 of 13 patients.
Thus, M-mode echocardiography is helpful in the recognition of cardiac
amyloidosis. However, the better appreciation with 2D echocardiography of
thickened cardiac walls with a "granular sparkling" appearance in patients
with unexplained cardiac failure is virtually diagnostic of cardiac
amyloidosis.
ARTICLES
M-mode and two-dimensional echocardiographic features in cardiac amyloidosis
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