Author + information
- Erin O'Donnell,
- Kyle Klarich,
- Adelaide Olson,
- Grace Lin,
- Peter Brady,
- Angela Dispenzieri,
- Morie Gertz,
- Steven Zeldenrust and
- Martha Grogan
Although characteristic electrocardiographic (ECG) findings have been reported in light-chain amyloid (AL) with cardiac involvement, the ECG findings in transthyretin-related (TTR) cardiac amyloidosis have not been well described. The purpose of this study was to determine the ECG findings in a large series of patients with hereditary and senile (wild-type) TTR cardiac amyloid.
We identified 259 patients with biopsy proven TTR amyloid (177 senile, 82 hereditary) and echocardiographic evidence of cardiac involvement seen at our institution. The standard 12-lead ECG tracing closest to the date of diagnosis was reviewed.
Table 1. Electrocardiographic Changes in All TTR Patients and Subsets of Patients with Senile and Hereditary TTR Amyloidosis.
In this large series of patients with TTR cardiac amyloid, low QRS voltage was uncommon. Although the ECG findings showed a greater frequency of pseudoinfarct pattern compared to low voltage in TTR patients, both were significantly less common than in the previously reported series of AL amyloid (45% and 47%, respectively). Conduction system disease was frequent in both forms of TTR cardiac amyloidosis, and atrial fibrillation was more commonly present in the senile type compared to hereditary TTR. Recognition of the distinct ECG findings in patients with TTR cardiac amyloid, especially the infrequency of low QRS voltage, has important diagnostic implications.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: What Is Unfolding in Cardiac Amyloidosis Research?
Abstract Category: 23. Pericardial/Myocardial Disease
Presentation Number: 1163-142
- 2013 American College of Cardiology Foundation