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. Author manuscript; available in PMC: 2021 Jun 1.
Published in final edited form as: JACC Cardiovasc Imaging. 2019 Oct 11;13(6):1368–1383. doi: 10.1016/j.jcmg.2019.07.015

FIGURE 1. Echocardiography in CA.

FIGURE 1

In the context of a thick Left ventricle (LV), the following features should be considered red flags for cardiac amyloidosis (CA): (A) pericardial and/or pleural effusions, thick right ventricle, thick valves, thick interatrial septum, small LV cavity size with low stroke volume, and paradoxical low flow, low gradient aortic stenosis. (B) Advanced CA results in restrictive LV filling patterns with rapid E-wave deceleration time, a predominant S wave on pulmonary venous Doppler, and low myocardial relaxation velocities on tissue Doppler imaging (TDI) at the mitral annulus. Finally, amyloid infiltration impairs (C) global Longitudinal strain (GLS) characteristically with apical sparing of the LV apex, in contrast to a normal pattern, and severely reduced contractile function of the atrial myocardium, in contrast to a normal pattern.

AS = aortic stenosis.