ATRIAL SYSTOLIC FAILURE IN PRIMARY AMYLOIDOSIS

CARDIAC involvement in primary (AL) amyloidosis commonly results in progressive heart failure owing to restriction of ventricular filling (restrictive cardiomyopathy).1 2 3 4 5 (AL stands for “amyloid light chain,” describing the protein deposited in tissues in this disorder.) There is considerable variability among patients in the hemodynamic findings associated with this disease, and recent studies using pulsed Doppler echocardiography and radionuclide ventriculography have described a spectrum of left ventricular filling abnormalities that appear to be related to disease progression and severity.6 , 7 In the early stages of cardiac amyloid infiltration, a relative shift of left ventricular filling from early to late diastole with enhancement… © 1992, Massachusetts Medical Society. All rights reserved.