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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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01. History of Cardiology
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07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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CLEAR FILTERS
ECHOCARDIOGRAPHY RED FLAGS FOR CARDIAC AMYLOIDOSIS IN PATIENTS WITH SEVERE AORTIC STENOSIS
Session:
Painel 3 - Imagiologia Cardiovascular 4
Speaker:
Valdirene Gonçalves
Congress:
CPC 2020
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.1 Echocardiography
Session Type:
Posters
FP Number:
---
Authors:
Valdirene Gonçalves; José Paulo Almeida; André Azul Freitas; Patrícia M. Alves; João André Ferreira; Leticia Bento; Sofia S. Martinho; Cátia Santos Ferreira; Ana Vera Marinho; James Milner; Rui M. Martins; Henrique Vieira; Lino Gonçalves
Abstract
<p><em><strong>BACKGROUND:</strong></em></p> <p>Aortic stenosis (AS) is the most common valvular heart disease and its prevalence increases with the age as well as Cardiac Amyloidosis (CA). It´s estimated that ≤15% of the AS population and ≤30% of the subset with low-flow low-gradient (LF-LG) pattern may have CA. Recent studies suggest that the coexistence of AS and CA is more common than previously anticipated.</p> <p>Until now, there is no recommendation or consensus on whether patients with AS should be systematically screened for CA.</p> <p>Our aim was to analyze the prevalence of echocardiography Red Flags (RF) for CA in patients with severe aortic stenosis (SAS).</p> <p> </p> <p><em><strong>METHODS</strong></em></p> <p>We did a retrospective analysis on 153 echocardiograms (ETT) of patients with SAS performed in the last 3 years and RF for CA was systematically searched [severe left ventricular (LV) longitudinal systolic dysfunction with apical sparing (APS); LV global longitudinal strain (GLS) ≥ -12%; apex/basal longitudinal strain ratio (GLSr) >2; mitral S' (MS´) ≤6 cm/s; right ventricular wall (RVW) thickening >5 mm; myocardial granular sparkling (MGS); atrial septal (ASP) thickening and biatrial dilatation (BAD); atrioventricular valve (AV) thickening >2 mm; moderate/severe pulmonary hypertension (PHT)]. </p> <p> </p> <p><em><strong>RESULTS</strong></em></p> <p>Of the 153 patients with SAS 78 was male (median age 77 years; range 52 to 93 years) and all had hypertension and heart failure (New York Heart Association functional class II/IV). All had LV hypertrophy (median wall thickness, 16 mm; range 14 to 20 mm) with a mean of calculated aortic valve area ≤0.6 cm2/m2. In 65 (42,8%) patients, a LF-LG condition was present. The RF found were, GLS ≥ -12% in 21 (14%) patients and APS in 23 (15%), MS´≤ 6 in 91 (90%), GLSr > 2 in 23 (15%), RVW >5 mm in 74 (49%), MGS in 21 (13,8%), AV > 2mm in 52 (34%), ASP thickening in 53 (35%), BAD in 51 (33,6%), PHT in 27 (18%).</p> <p>Remarkably, all echocardiographic RF was present in 19 (12%) patients.</p> <p> </p> <p><em><strong>CONCLUSION</strong></em></p> <p>In this study, we saw that the RF for CA are common in patients with AS. The study cannot provide data on sensitivity and specificity but suggest that echocardiography plays a central role in the screening and particular attention should be paid to echocardiographic signs. </p> <p>More studies are needed to establish in which patients with AS we should search for CA.</p>
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