Journal of the American Society of Echocardiography
Volume 22, Issue 12 , Pages 1396-1402 , December 2009

Left Ventricular Ejection Time on Echocardiography Predicts Long-Term Mortality in Light Chain Amyloidosis

  • Raymond Q. Migrino, MD

      Affiliations

    • Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
    • Corresponding Author InformationReprint requests: Raymond Q. Migrino, MD, Medical College of Wisconsin-CVM, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226.
  • ,
  • Ravi K. Mareedu, MD

      Affiliations

    • Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
  • ,
  • Daniel Eastwood, MS

      Affiliations

    • Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin
  • ,
  • Mark Bowers, MD

      Affiliations

    • Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
  • ,
  • Leanne Harmann, BA

      Affiliations

    • Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
  • ,
  • Parameswaran Hari, MD

      Affiliations

    • Hematology-Oncology Division, Medical College of Wisconsin, Milwaukee, Wisconsin

References 

  1. Comenzo RL, Vosburgh E, Simms RW, Bergethon P, Sarnacki D, Finn K, et al. Dose-intensive melphalan with blood stem cell support for the treatment of AL amyloidosis: one-year follow-up in five patients. Blood. 1996;88:2801–2806
  2. Falk RH. Diagnosis and management of the cardiac amyloidoses. Circulation. 2005;112:2047–2060
  3. Sanchorawala V, Wright DG, Seldin DC, Dember LM, Finn K, Falk RH, et al. An overview of the use of high-dose melphalan with autologous stem cell transplantation for the treatment of AL amyloidosis. Bone Marrow Transplant. 2001;28:637–642
  4. Kyle RA, Gertz MA. Primary systemic amyloidosis: clinical and laboratory features in 474 cases. Semin Hematol. 1995;32:45–59
  5. Dispenzieri A, Gertz MA, Kyle RA, Lacy MQ, Burritt MF, Therneau TM, et al. Prognostication of survival using cardiac troponins and N-terminal pro-brain natriuretic peptide in patients with primary systemic amyloidosis undergoing peripheral blood stem cell transplantation. Blood. 2004;104:1881–1887
  6. Klein AL, Hatle LK, Burstow DJ, Seward JB, Kyle RA, Bailey KR, et al. Doppler characterization of left ventricular diastolic function in cardiac amyloidosis. J Am Coll Cardiol. 1989;13:1017–1026
  7. Klein AL, Hatle LK, Taliercio CP, Taylor CL, Kyle RA, Bailey KR, et al. Serial Doppler echocardiographic follow-up of left ventricular diastolic function in cardiac amyloidosis. J Am Coll Cardiol. 1990;16:1135–1141
  8. Siqueira-Filho AG, Cunha CL, Tajik AJ, Seward JB, Schattenberg TT, Giuliani ER. M-mode and two-dimensional echocardiographic features in cardiac amyloidosis. Circulation. 1981;63:188–196
  9. Koyama J, Davidoff R, Falk RH. Longitudinal myocardial velocity gradient derived from pulsed Doppler tissue imaging in AL amyloidosis: a sensitive indicator of systolic and diastolic dysfunction. J Am Soc Echocardiogr. 2004;17:36–44
  10. Koyama J, Ray-Sequin PA, Davidoff R, Falk RH. Usefulness of pulsed tissue Doppler imaging for evaluating systolic and diastolic left ventricular function in patients with AL (primary) amyloidosis. Am J Cardiol. 2002;89:1067–1071
  11. Bellavia D, Pellikka PA, Abraham TP, Al-Zahrani G, Dispenzieri A, Oh J, et al. “Hypersynchronization” by tissue velocity imaging in patients with cardiac amyloidosis. Heart (British Cardiac Society). 2008;95:234–240
  12. Migrino RQ, Harmann L, Woods T, Bright M, Truran S, Hari P. Intraventricular dyssynchrony in light chain amyloidosis: a new mechanism of systolic dysfunction assessed by 3-dimensional echocardiography. Cardiovasc Ultrasound. 2008;6:40
  13. Klein AL, Hatle LK, Taliercio CP, Oh JK, Kyle RA, Gertz MA, et al. Prognostic significance of Doppler measures of diastolic function in cardiac amyloidosis. A Doppler echocardiography study. Circulation. 1991;83:808–816
  14. Tei C, Dujardin KS, Hodge DO, Kyle RA, Tajik AJ, Seward JB. Doppler index combining systolic and diastolic myocardial performance: clinical value in cardiac amyloidosis. J Am Coll Cardiol. 1996;28:658–664
  15. Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol. 1986;57:450–458
  16. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18:1440–1463
  17. The Criteria Committee of the New York Heart Association. Nomenclature and criteria for diagnosis of diseases of the heart and blood vessels. Boston: Little Brown; 1964;
  18. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–481
  19. Alam M, Wardell J, Andersson E, Nordlander R, Samad B. Assessment of left ventricular function using mitral annular velocities in patients with congestive heart failure with or without the presence of significant mitral regurgitation. J Am Soc Echocardiogr. 2003;16:240–245
  20. Nikitin NP, Loh PH, Silva R, Ghosh J, Khaleva OY, Goode K, et al. Prognostic value of systolic mitral annular velocity measured with Doppler tissue imaging in patients with chronic heart failure caused by left ventricular systolic dysfunction. Heart (British Cardiac Society). 2006;92:775–779
  21. Dubrey SW, Cha K, Anderson J, Chamarthi B, Reisinger J, Skinner M, et al. The clinical features of immunoglobulin light-chain (AL) amyloidosis with heart involvement. QJM. 1998;91:141–157
  22. Sirohi B, Powles R. Epidemiology and outcomes research for MGUS, myeloma and amyloidosis. Eur J Cancer. 2006;42:1671–1683
  23. Maceira AM, Joshi J, Prasad SK, Moon JC, Perugini E, Harding I, et al. Cardiovascular magnetic resonance in cardiac amyloidosis. Circulation. 2005;111:186–193
  24. Migrino RQ, Christenson R, Szabo A, Bright M, Truran S, Hari P. Prognostic implication of late gadolinium enhancement on cardiac MRI in light chain (AL) amyloidosis on long term follow up. BMC Med Phys. 2009;9:5
  25. Murakami Y, Hozawa A, Okamura T, Ueshima H. Relation of blood pressure and all-cause mortality in 180,000 Japanese participants: pooled analysis of 13 cohort studies. Hypertension. 2008;51:1483–1491
  26. Chan GS, Middleton PM, Celler BG, Wang L, Lovell NH. Automatic detection of left ventricular ejection time from a finger photoplethysmographic pulse oximetry waveform: comparison with Doppler aortic measurement. Physiol Meas. 2007;28:439–452
  27. Lewis RP. Diagnostic value of systolic time intervals in man. Cardiovasc Clin. 1975;6:245–264
  28. Lewis RP, Rittogers SE, Froester WF, Boudoulas H. A critical review of the systolic time intervals. Circulation. 1977;56:146–158
  29. Weissler AM, Harris WS, Schoenfeld CD. Bedside technics for the evaluation of ventricular function in man. Am J Cardiol. 1969;23:577–583
  30. Geeraerts T, Albaladejo P, Declere AD, Duranteau J, Sales JP, Benhamou D. Decrease in left ventricular ejection time on digital arterial waveform during simulated hypovolemia in normal humans. J Trauma. 2004;56:845–849
  31. Wizenberg TA, Muz J, Sohn YH, Samlowski W, Weissler AM. Value of positive myocardial technetium-99 m-pyrophosphate scintigraphy in the noninvasive diagnosis of cardiac amyloidosis. Am Heart J. 1982;103(4 Pt 1):468–473
  32. Cheng HM, Yu WC, Sung SH, Wang KL, Chuang SY, Chen CH. Usefulness of systolic time intervals in the identification of abnormal ventriculo-arterial coupling in stable heart failure patients. Eur J Heart Fail. 2008;10:1192–1200Epub 2008 Nov 11
  33. Gertz MA, Lacy MQ, Dispenzieri A, Hayman SR, Kumar S. Transplantation for amyloidosis. Curr Opin Oncol. 2007;19:136–141
  34. Jantunen E, Itala M, Lehtinen T, Kuittinen O, Koivunen E, Leppa S, et al. Early treatment-related mortality in adult autologous stem cell transplant recipients: a nation-wide survey of 1482 transplanted patients. Eur J Haematol. 2006;76:245–250
  35. Vesole DH, Perez WS, Akasheh M, Boudreau C, Reece DE, Bredeson CN. High-dose therapy and autologous hematopoietic stem cell transplantation for patients with primary systemic amyloidosis: a Center for International Blood and Marrow Transplant Research Study. Mayo Clinic Proc. 2006;81:880–888
  36. Comenzo RL, Gertz MA. Autologous stem cell transplantation for primary systemic amyloidosis. Blood. 2002;99:4276–4282
  37. Bellavia D, Abraham TP, Pellikka PA, Al-Zahrani GB, Dispenzieri A, Oh JK, et al. Detection of left ventricular systolic dysfunction in cardiac amyloidosis with strain rate echocardiography. J Am Soc Echocardiogr. 2007;20:1194–1202

 The study was supported by the American Heart Association Grant in Aid 0855683G, National Institutes of Health R21HL092344-01A1, GCRC M01-RR00058 and Kirschtein National Research Service Award, Amyloidosis Research Foundation, American Cancer Society, and Greater Milwaukee Foundation. The Biostatistics Consulting Service is supported by the Division of Biostatistics and the Clinical Translational Science Institute of Southeast Wisconsin.

 The authors had full access to the data and take responsibility for its integrity. All authors have read and agree to the article as written.

PII: S0894-7317(09)00855-4

doi: 10.1016/j.echo.2009.09.012

Journal of the American Society of Echocardiography
Volume 22, Issue 12 , Pages 1396-1402 , December 2009