Prevalence and Prognostic Value of Conduction Disturbances at the Time of Diagnosis of Cardiac AL Amyloidosis
Article first published online: 20 JAN 2013
©2013, Wiley Periodicals, Inc.
Annals of Noninvasive Electrocardiology
Volume 18, Issue 4, pages 327–335, July 2013
How to Cite
Boldrini, M., Salinaro, F., Mussinelli, R., Raimondi, A., Alogna, A., Musca, F., Palladini, G., Merlini, G. and Perlini, S. (2013), Prevalence and Prognostic Value of Conduction Disturbances at the Time of Diagnosis of Cardiac AL Amyloidosis. Annals of Noninvasive Electrocardiology, 18: 327–335. doi: 10.1111/anec.12032
- Issue published online: 23 JUL 2013
- Article first published online: 20 JAN 2013
- conduction disturbances;
Background and purpose
To evaluate the prevalence and the prognostic implications of conduction delays in a large cohort of cardiac AL patients.
Echo Doppler and 12-lead ECG were collected in 344 consecutive patients in whom diagnosis of AL amyloidosis was concluded between 2008 and 2010. Patients were subdivided according to the presence (n = 240) or absence (n = 104) of cardiac involvement.
When compared with patients without myocardial involvement, cardiac AL was associated with prolonged PQ, QRS, QT and QTc intervals (P < 0.05), and with higher prevalence of intraventricular blocks (27.5% vs. 16.5%, P < 0.05), that was associated with higher wall thickness, worse diastolic and regional systolic function, higher NT-proBNP values (all P < 0.05), and higher mortality (P = 0.0001; median follow-up: 402 days).
Intraventricular conduction delays have a negative prognostic impact in patients with cardiac AL amyloidosis. Their presence should not be overlooked in the diagnostic workup, prompting a more accurate cardiological support.