Intraventricular dyssynchrony in light chain amyloidosis

A new mechanism of systolic dysfunction assessed by 3-dimensional echocardiography

Raymond Q. Migrino, Leanne Harmann, Timothy Woods, Megan Bright, Seth Truran, Parameswaran Hari

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background. Light chain amyloidosis (AL) is a rare but often fatal disease due to intractable heart failure. Amyloid deposition leads to diastolic dysfunction and often preserved ejection fraction. We hypothesize that AL is associated with regional systolic dyssynchrony. The aim is to compare left ventricular (LV) regional synchrony in AL subjects versus healthy controls using 16-segment dyssynchrony index measured from 3-dimension-al (3D) echocardiography. Methods. Cardiac 3D echocardiography full volumes were acquired in 10 biopsy-proven AL subjects (60 ± 3 years, 5 females) and 10 healthy controls (52 ± 1 years, 5 females). The LV was subdivided into 16 segments and the time from end-diastole to the minimal systolic volume for each of the 16 segments was expressed as a percent of the cycle length. The standard deviations of these times provided a 16-segment dyssynchrony index (16-SD%). 16-SD% was compared between healthy and AL subjects. Results. Left ventricular ejection fraction was comparable (control vs. AL: 62.4 ± 0.6 vs. 58.6 ± 2.8%, p = NS). 16-SD% was significantly higher in AL versus healthy subjects (5.93 ± 4.4 vs. 1.67 ± 0.87%, p = 0.003). 16-SD% correlated with left ventricular mass index (R 0.45, p = 0.04) but not to left ventricular ejection fraction. Conclusion. Light chain amyloidosis is associated with left ventricular regional systolic dyssynchrony. Regional dyssynchrony may be an unrecognized mechanism of heart failure in AL subjects.

Original languageEnglish (US)
Article number40
JournalCardiovascular Ultrasound
Volume6
DOIs
StatePublished - Sep 1 2008
Externally publishedYes

Fingerprint

Amyloidosis
Echocardiography
Light
Healthy Volunteers
Stroke Volume
Heart Failure
Diastole
Amyloid
Biopsy

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Intraventricular dyssynchrony in light chain amyloidosis : A new mechanism of systolic dysfunction assessed by 3-dimensional echocardiography. / Migrino, Raymond Q.; Harmann, Leanne; Woods, Timothy; Bright, Megan; Truran, Seth; Hari, Parameswaran.

In: Cardiovascular Ultrasound, Vol. 6, 40, 01.09.2008.

Research output: Contribution to journalArticle

@article{c7be3153e90145a697ec35c30d8454cb,
title = "Intraventricular dyssynchrony in light chain amyloidosis: A new mechanism of systolic dysfunction assessed by 3-dimensional echocardiography",
abstract = "Background. Light chain amyloidosis (AL) is a rare but often fatal disease due to intractable heart failure. Amyloid deposition leads to diastolic dysfunction and often preserved ejection fraction. We hypothesize that AL is associated with regional systolic dyssynchrony. The aim is to compare left ventricular (LV) regional synchrony in AL subjects versus healthy controls using 16-segment dyssynchrony index measured from 3-dimension-al (3D) echocardiography. Methods. Cardiac 3D echocardiography full volumes were acquired in 10 biopsy-proven AL subjects (60 ± 3 years, 5 females) and 10 healthy controls (52 ± 1 years, 5 females). The LV was subdivided into 16 segments and the time from end-diastole to the minimal systolic volume for each of the 16 segments was expressed as a percent of the cycle length. The standard deviations of these times provided a 16-segment dyssynchrony index (16-SD{\%}). 16-SD{\%} was compared between healthy and AL subjects. Results. Left ventricular ejection fraction was comparable (control vs. AL: 62.4 ± 0.6 vs. 58.6 ± 2.8{\%}, p = NS). 16-SD{\%} was significantly higher in AL versus healthy subjects (5.93 ± 4.4 vs. 1.67 ± 0.87{\%}, p = 0.003). 16-SD{\%} correlated with left ventricular mass index (R 0.45, p = 0.04) but not to left ventricular ejection fraction. Conclusion. Light chain amyloidosis is associated with left ventricular regional systolic dyssynchrony. Regional dyssynchrony may be an unrecognized mechanism of heart failure in AL subjects.",
author = "Migrino, {Raymond Q.} and Leanne Harmann and Timothy Woods and Megan Bright and Seth Truran and Parameswaran Hari",
year = "2008",
month = "9",
day = "1",
doi = "10.1186/1476-7120-6-40",
language = "English (US)",
volume = "6",
journal = "Cardiovascular Ultrasound",
issn = "1476-7120",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Intraventricular dyssynchrony in light chain amyloidosis

T2 - A new mechanism of systolic dysfunction assessed by 3-dimensional echocardiography

AU - Migrino, Raymond Q.

AU - Harmann, Leanne

AU - Woods, Timothy

AU - Bright, Megan

AU - Truran, Seth

AU - Hari, Parameswaran

PY - 2008/9/1

Y1 - 2008/9/1

N2 - Background. Light chain amyloidosis (AL) is a rare but often fatal disease due to intractable heart failure. Amyloid deposition leads to diastolic dysfunction and often preserved ejection fraction. We hypothesize that AL is associated with regional systolic dyssynchrony. The aim is to compare left ventricular (LV) regional synchrony in AL subjects versus healthy controls using 16-segment dyssynchrony index measured from 3-dimension-al (3D) echocardiography. Methods. Cardiac 3D echocardiography full volumes were acquired in 10 biopsy-proven AL subjects (60 ± 3 years, 5 females) and 10 healthy controls (52 ± 1 years, 5 females). The LV was subdivided into 16 segments and the time from end-diastole to the minimal systolic volume for each of the 16 segments was expressed as a percent of the cycle length. The standard deviations of these times provided a 16-segment dyssynchrony index (16-SD%). 16-SD% was compared between healthy and AL subjects. Results. Left ventricular ejection fraction was comparable (control vs. AL: 62.4 ± 0.6 vs. 58.6 ± 2.8%, p = NS). 16-SD% was significantly higher in AL versus healthy subjects (5.93 ± 4.4 vs. 1.67 ± 0.87%, p = 0.003). 16-SD% correlated with left ventricular mass index (R 0.45, p = 0.04) but not to left ventricular ejection fraction. Conclusion. Light chain amyloidosis is associated with left ventricular regional systolic dyssynchrony. Regional dyssynchrony may be an unrecognized mechanism of heart failure in AL subjects.

AB - Background. Light chain amyloidosis (AL) is a rare but often fatal disease due to intractable heart failure. Amyloid deposition leads to diastolic dysfunction and often preserved ejection fraction. We hypothesize that AL is associated with regional systolic dyssynchrony. The aim is to compare left ventricular (LV) regional synchrony in AL subjects versus healthy controls using 16-segment dyssynchrony index measured from 3-dimension-al (3D) echocardiography. Methods. Cardiac 3D echocardiography full volumes were acquired in 10 biopsy-proven AL subjects (60 ± 3 years, 5 females) and 10 healthy controls (52 ± 1 years, 5 females). The LV was subdivided into 16 segments and the time from end-diastole to the minimal systolic volume for each of the 16 segments was expressed as a percent of the cycle length. The standard deviations of these times provided a 16-segment dyssynchrony index (16-SD%). 16-SD% was compared between healthy and AL subjects. Results. Left ventricular ejection fraction was comparable (control vs. AL: 62.4 ± 0.6 vs. 58.6 ± 2.8%, p = NS). 16-SD% was significantly higher in AL versus healthy subjects (5.93 ± 4.4 vs. 1.67 ± 0.87%, p = 0.003). 16-SD% correlated with left ventricular mass index (R 0.45, p = 0.04) but not to left ventricular ejection fraction. Conclusion. Light chain amyloidosis is associated with left ventricular regional systolic dyssynchrony. Regional dyssynchrony may be an unrecognized mechanism of heart failure in AL subjects.

UR - http://www.scopus.com/inward/record.url?scp=50249118246&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=50249118246&partnerID=8YFLogxK

U2 - 10.1186/1476-7120-6-40

DO - 10.1186/1476-7120-6-40

M3 - Article

VL - 6

JO - Cardiovascular Ultrasound

JF - Cardiovascular Ultrasound

SN - 1476-7120

M1 - 40

ER -