Cardiac Amyloidosis Detected on Imaging of Patients with Heart Failure

11 November 2020: Articles

Challenging differential diagnosis, Unusual setting of medical care, Rare disease

Siniša Roginić ^A* , Ozren Vinter ^A , Matias Trbušić ^C , Martina Roginić ^A , Edina Ćatić Ćuti ^A

DOI: 10.12659/AJCR.926290

Am J Case Rep 2020; 21:e926290

Table 1. Clinical and echocardiography data from our patients.

	Patient 1	Patient 2	Patient 3
Sex/age	Male/63	Female/72	Female/55
Hematologic diagnosis	Multiple myeloma and AL amyloidosis – lambda light chains	Multiple myeloma and AL amyloidosis – lambda light chains	Multiple myeloma and AL amyloidosis – lambda light chains
Time from symptom onset to diagnosis	5 months	6 months	5 months
Extracardiac involvement	Kidney, tongue, skin, heart	Tongue, liver, kidney, heart	Tongue, liver, kidney, heart
NT-proBNP	13 900 ng/L	10 940 ng/L	5225 ng/L
hs-TnI	92.9 ng/L	138.4 ng/L	53.6 ng//L
Left ventricle size (EDV/ESV)	80 mL/40 mL	43 mL/27 mL	77 mL/28 mL
Left ventricular mass index	122 g/m	133 g/m	120 g/m
Septal thickness	15 mm	15 mm	13 mm
EF	50%	37%	37%
GLS	−7%	−6%	−9%
RRSR	–	1.48	1.47
EF/GLS ratio	7.1	6.2	4.2
Diastolic function
E vel	1.3 m/s	1.1 m/s	0.84 m/s
A vel	0.36 m/s	0.38 m/s	0.4 m/s
E/A	3.1	2.8	2.2
DecT	149 ms	162 ms	176 ms
E/e’	28	38	21
A vel – A velocity; AL – primary amyloidosis; DecT – mitral inflow deceleration time; E/A – ratio of the early diastole (the E wave) to peak velocity flow in late diastole caused by atrial contraction (the A wave); EDV – end-diastolic volume; E/e’ – ratio between early mitral inflow velocity and mitral annular early diastolic velocity; EF – ejection fraction; ESV – end-systolic volume; E vel – E velocity; GLS – global longitudinal strain; hs-Tnl – highly sensitive troponin; NT-proBNP – N-terminal pro b-type natriuretic peptide; RRSR – relative regional strain ratio.