Nobuoka S, Hatano S, Nagashima J, Miyake F
Division of Cardiology, St. Marianna University School of Medicine.
Nihon Rinsho. 2000 Jan;58(1):177-80.
In our experience, QS pattern of poor R wave progression and atrio-ventricular block of varying degrees on electrocardiogram, cardiomegaly with pleural effusion on chest X-ray film, left ventricular wall thickening, pericardial effusion and findings suggesting left ventricular diastolic dysfunction on echocardiogram and increased right ventricular end-diastolic pressure in cardiac catheterization were frequently observed in patients with cardiac amyloidosis. Though none of these findings are specific, we should suspect cardiac amyloidosis as a possibility when some of these signs are observed in patients with chronic cardiac failure of unknown etiology. Left ventricular mass obtained from echocardiography could be useful predictive parameter of prognosis in patients with cardiac amyloidosis.
根据我们的经验,心脏淀粉样变性患者常出现以下表现:心电图显示R波进展不良的QS型以及不同程度的房室传导阻滞;胸部X光片显示心脏增大伴胸腔积液;超声心动图显示左心室壁增厚、心包积液以及提示左心室舒张功能障碍的表现;心导管检查显示右心室舒张末期压力升高。虽然这些表现均不具有特异性,但在病因不明的慢性心力衰竭患者中若观察到其中一些体征,我们应怀疑心脏淀粉样变性的可能性。超声心动图测得的左心室质量可能是心脏淀粉样变性患者预后的有用预测参数。