Thursday, February 17, 2011

Electrocardiography and echocardiography in the diagnosis of cardiac amyloidosis

Electrocardiography and echocardiography are emerging as powerful noninvasive diagnostic techniques in the diagnosis of cardiac amyloidosis. A new paper in the Annals of Noninvasive Electrocardiography reports:


Results: The voltage of SV1+ RV6 less than 1.2 mV has a sensitivity of 91% and specificity of 89% for the identification of primary CA, yields the positive and negative predictive values of 91% and 89%, respectively. Among ECHO parameters, there were no significant differences between the 2 groups, except for left ventricular ejection fraction (47 ± 12% in primary CA vs 67 ± 11% in the control, P less than 0.001). However, the combined indexes of ECG and ECHO parameters, including the ratio of RI/LVPW as well as RV5/LVPW and RV6/LVPW, were significantly lower in the patients with primary CA than the control. The ratio of RI/LVPW less than 0.4 has the sensitivity of 91% and specificity of 100%, yields the positive and negative predictive values of 100% and 91%, respectively. The ratios of RV5(6)/LVPW less than 0.7 have the sensitivity of 91% and specificity of 89%, yield the positive and negative predictive values of 91% and 89%, respectively.
Conclusion: Patients with clinically suspected primary CA, combined indexes of ECGs and ECHOs could be used as the noninvasive diagnostic tools.


By primary CA I believe the authors, although this is not explicit, mean AL amyloidosis with cardiac involvement as opposed to either senile or hereditary transthyretin related amyloidosis.


Related post here.

No comments: