Skip to main content
NCBI home page
British Heart Journal logoLink to British Heart Journal
. 1989 Feb;61(2):198–203. doi: 10.1136/hrt.61.2.198

Impaired left ventricular diastolic filling in patients with familial amyloid polyneuropathy: a pulsed Doppler echocardiographic study.

O Kinoshita 1, M Hongo 1, H Yamada 1, T Misawa 1, J Kono 1, S Okubo 1, S Ikeda 1
PMCID: PMC1216641  PMID: 2923760

Abstract

To assess left ventricular diastolic filling in patients with amyloid heart disease 12 patients with familial amyloid polyneuropathy and 15 normal subjects were studied by pulsed Doppler echocardiography. None of the patients had clinical evidence of overt heart disease or restrictive cardiomyopathy and only two of them showed ventricular wall thickening. The peak flow velocity of rapid diastolic filling and the acceleration rate of early diastolic inflow were significantly lower in patients with familial amyloid polyneuropathy than in controls. The pressure half time was significantly longer in patients than in controls. In addition, the peak flow velocity during atrial contraction and the ratio of atrial peak flow velocity to rapid diastolic peak flow velocity were significantly greater in patients than in controls. Although there were no significant correlations between measurements of diastolic filling and clinical findings in patients with familial amyloid polyneuropathy, the ratio of atrial peak flow velocity to rapid diastolic peak flow velocity was significantly related to left ventricular posterior wall thickness. These findings suggest that in patients with cardiac amyloidosis without restrictive cardiomyopathy, abnormal left ventricular diastolic filling, manifested by a reduction in the rate and volume of rapid diastolic filling with enhanced atrial contraction, can be seen even in the early stage of the disease.

Full text

PDF
198

Images in this article

199Fig 1
on p.199

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bhandari A. K., Nanda N. C. Myocardial texture characterization by two-dimensional echocardiography. Am J Cardiol. 1983 Mar 1;51(5):817–825. doi: 10.1016/s0002-9149(83)80139-8. [DOI] [PubMed] [Google Scholar]
  2. Borer J. S., Henry W. L., Epstein S. E. Echocardiographic observations in patients with systemic infiltrative disease involving the heart. Am J Cardiol. 1977 Feb;39(2):184–188. doi: 10.1016/s0002-9149(77)80189-6. [DOI] [PubMed] [Google Scholar]
  3. Buja L. M., Khoi N. B., Roberts W. C. Clinically significant cardiac amyloidosis. Clinicopathologic findings in 15 patients. Am J Cardiol. 1970 Oct;26(4):394–405. doi: 10.1016/0002-9149(70)90736-8. [DOI] [PubMed] [Google Scholar]
  4. Chew C., Ziady G. M., Raphael M. J., Oakley C. M. The functional defect in amyloid heart disease. The "stiff heart" syndrome. Am J Cardiol. 1975 Oct 6;36(4):438–444. doi: 10.1016/0002-9149(75)90891-7. [DOI] [PubMed] [Google Scholar]
  5. Cueto-Garcia L., Tajik A. J., Kyle R. A., Edwards W. D., Wood D. L., Seward J. B. Echocardiographic features of amyloid ischemic heart disease. Am J Cardiol. 1985 Feb 15;55(5):606–607. doi: 10.1016/0002-9149(85)90268-1. [DOI] [PubMed] [Google Scholar]
  6. Hongo M., Hirayama J., Fujii T., Yamada H., Okubo S., Kusama S., Ikeda S. Early identification of amyloid heart disease by technetium-99m-pyrophosphate scintigraphy: a study with familial amyloid polyneuropathy. Am Heart J. 1987 Mar;113(3):654–662. doi: 10.1016/0002-8703(87)90703-4. [DOI] [PubMed] [Google Scholar]
  7. Hongo M., Ikeda S. Echocardiographic assessment of the evolution of amyloid heart disease: a study with familial amyloid polyneuropathy. Circulation. 1986 Feb;73(2):249–256. doi: 10.1161/01.cir.73.2.249. [DOI] [PubMed] [Google Scholar]
  8. Ikeda S., Hanyu N., Hongo M., Yoshioka J., Oguchi H., Yanagisawa N., Kobayashi T., Tsukagoshi H., Ito N., Yokota T. Hereditary generalized amyloidosis with polyneuropathy. Clinicopathological study of 65 Japanese patients. Brain. 1987 Apr;110(Pt 2):315–337. doi: 10.1093/brain/110.2.315. [DOI] [PubMed] [Google Scholar]
  9. Kim S. G. The management of patients with life-threatening ventricular tachyarrhythmias: programmed stimulation or Holter monitoring (either or both)? Circulation. 1987 Jul;76(1):1–5. doi: 10.1161/01.cir.76.1.1. [DOI] [PubMed] [Google Scholar]
  10. Meaney E., Shabetai R., Bhargava V., Shearer M., Weidner C., Mangiardi L. M., Smalling R., Peterson K. Cardiac amyloidosis, contrictive pericarditis and restrictive cardiomyopathy. Am J Cardiol. 1976 Nov 4;38(5):547–556. doi: 10.1016/s0002-9149(76)80001-x. [DOI] [PubMed] [Google Scholar]
  11. Saffitz J. E., Sazama K., Roberts W. C. Amyloidosis limited to small arteries causing angina pectoris and sudden death. Am J Cardiol. 1983 Apr;51(7):1234–1235. doi: 10.1016/0002-9149(83)90379-x. [DOI] [PubMed] [Google Scholar]
  12. Sahn D. J., DeMaria A., Kisslo J., Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation. 1978 Dec;58(6):1072–1083. doi: 10.1161/01.cir.58.6.1072. [DOI] [PubMed] [Google Scholar]
  13. Smith R. R., Hutchins G. M. Ischemic heart disease secondary to amyloidosis of intramyocardial arteries. Am J Cardiol. 1979 Sep;44(3):413–417. doi: 10.1016/0002-9149(79)90389-8. [DOI] [PubMed] [Google Scholar]
  14. St John Sutton M. G., Reichek N., Kastor J. A., Giuliani E. R. Computerized M-mode echocardiographic analysis of left ventricular dysfunction in cardiac amyloid. Circulation. 1982 Oct;66(4):790–799. doi: 10.1161/01.cir.66.4.790. [DOI] [PubMed] [Google Scholar]
  15. Swanton R. H., Brooksby I. A., Davies M. J., Coltart D. J., Jenkins B. S., Webb-Peploe M. M. Systolic and diastolic ventricular function in cardiac amyloidosis. Studies in six cases diagnosed with endomyocardial biopsy. Am J Cardiol. 1977 May 4;39(5):658–664. doi: 10.1016/s0002-9149(77)80125-2. [DOI] [PubMed] [Google Scholar]
  16. Thomas J. D., Weyman A. E. Doppler mitral pressure half-time: a clinical tool in search of theoretical justification. J Am Coll Cardiol. 1987 Oct;10(4):923–929. doi: 10.1016/s0735-1097(87)80290-5. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES