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Ann Noninvasive Electrocardiol. 2013 Jul;18(4):327-35. doi: 10.1111/anec.12032. Epub 2013 Jan 20.

Prevalence and prognostic value of conduction disturbances at the time of diagnosis of cardiac AL amyloidosis.

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1
Clinica Medica II Department of Internal Medicine, Fondazione IRCCS San Matteo, University of Pavia, Italy.

Abstract

BACKGROUND AND PURPOSE:

To evaluate the prevalence and the prognostic implications of conduction delays in a large cohort of cardiac AL patients.

METHODS:

Echo Doppler and 12-lead ECG were collected in 344 consecutive patients in whom diagnosis of AL amyloidosis was concluded between 2008 and 2010. Patients were subdivided according to the presence (n = 240) or absence (n = 104) of cardiac involvement.

RESULTS:

When compared with patients without myocardial involvement, cardiac AL was associated with prolonged PQ, QRS, QT and QTc intervals (P < 0.05), and with higher prevalence of intraventricular blocks (27.5% vs. 16.5%, P < 0.05), that was associated with higher wall thickness, worse diastolic and regional systolic function, higher NT-proBNP values (all P < 0.05), and higher mortality (P = 0.0001; median follow-up: 402 days).

CONCLUSION:

Intraventricular conduction delays have a negative prognostic impact in patients with cardiac AL amyloidosis. Their presence should not be overlooked in the diagnostic workup, prompting a more accurate cardiological support.

KEYWORDS:

amyloid; conduction disturbances; echocardiography; electrocardiography; prognosis

PMID:
23879272
DOI:
10.1111/anec.12032
[Indexed for MEDLINE]
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