Open AccessEchocardiographic and Biohumoral Characteristics in Patients With AL and TTR Amyloidosis at Diagnosis
Author(s) -
Cappelli Francesco,
Baldasseroni Samuele,
Bergesio Franco,
Perlini Stefano,
Salinaro Francesco,
Padeletti Luigi,
Attanà Paola,
Paoletti Perini Alessandro,
Moggi Pig Alberto,
Grifoni Elisa,
Fabbri Alessia,
Marchionni Niccolò,
Gensini Gian Franco,
Perfetto Federico
Publication year - 2015
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22353
Subject(s) - transthyretin , medicine , amyloidosis , ejection fraction , cardiac amyloidosis , al amyloidosis , cardiology , heart failure , natriuretic peptide , amyloid (mycology) , pathology , immunoglobulin light chain , antibody , immunology
Background Few studies have analyzed the clinical and echocardiographic differences between light‐chain ( AL ) and transthyretin ( TTR ) amyloidosis. Hypothesis The aim of the present research was to compare, in a real‐world setting, the clinical and echocardiographic profiles of these kinds of amyloidosis, at the time of diagnosis, using new‐generation echocardiography. Methods Seventy‐nine patients with AL and 48 patients with TTR amyloidosis were studied. Results According to the criterion of mean left ventricular ( LV ) thickness >12 mm, 45 AL (C‐ AL ) and all TTR patients had cardiac amyloidotic involvement, whereas 34 AL patients did not. TTR patients had increased right ventricular ( RV ) and LV chambers with increased RV and LV wall thickness and reduced LV ejection fraction and fractional shortening. Furthermore, TTR patients showed lower N‐terminal pro Brain Natriuretic Peptide concentrations and New York Heart Association functional class when compared with C‐ AL . Conclusions Our data show that at time of first diagnosis, TTR patients have a more advanced amyloidotic involvement of the heart, despite less severe symptoms and biohumoral signs of heart failure. We can hypothesize that we observed different diseases at different stages. In fact, AL amyloidosis is a multiorgan disease with quick progression rate, that becomes rapidly symptomatic, whereas TTR amyloidosis might have a slow progression rate and might remain poorly symptomatic for a greater amount of time.