Korela Dafni, Foukarakis Emmanouil, Plevritaki Anthοula, Maragkoudakis Spyros, Anastasiou Ioannis, Patrianakos Alexandros, Kapsoritakis Nikolaos, Koukouraki Sophia, Bourogianni Olga, Pontikoglou Charalampos, Psillaki Maria, Padadaki Helen A, Zaganas Ioannis, Samonakis Dimitris, Detorakis Eustathios, Petrakis Ioannis, Stylianou Kostas, Chlouverakis Gregory, Giannakoudakis Emmanouil, Simantirakis Emmanouil, Kochiadakis George, Marketou Maria
Cardiology Department, Venizelion General Hospital of Heraklion, 71409 Heraklion, Greece.
School of Medicine, University of Crete, 70013 Heraklion, Greece.
J Clin Med. 2025 Mar 18;14(6):2078. doi: 10.3390/jcm14062078.
Cardiac amyloidosis (CA) is a progressive disorder characterized by amyloid fibril deposition in the heart, leading to heart failure and arrhythmias. Arterial stiffness, assessed by pulse wave velocity (PWV), is recognized as an adverse consequence of amyloidosis, yet its progression and relationship with myocardial dysfunction remain inadequately explored. This study examines the progression of PWV and its potential association with the deterioration of global longitudinal strain (GLS) in CA patients over a 6-month follow-up period. This prospective study enrolled 31 patients who were diagnosed with CA, including both the immunoglobulin light chain (AL) and transthyretin (ATTR) forms. All participants underwent a full echocardiographic study and PWV measurements (carotid-femoral [c-f] and carotid-radial [c-r] PWV) at baseline and 6-month follow-up. Age- and sex-matched individuals with similar cardiovascular risk factors were included as a control group. In the CA group, the left ventricular mass index (LVMI) increased significantly from 119.4 ± 52.1 to 124 ± 53.2 g/m ( = 0.002). Both c-f and c-r PWV showed significant increases at the 6-month follow-up ( < 0.001 and = 0.005, respectively). The GLS deteriorated significantly from -14 ± 4.4% to -12.8 ± 4.9% ( = 0.018). No significant changes were observed in the control group. A weak correlation (r = 0.3; = 0.095) was found between increases in PWV and GLS deterioration. Both arterial stiffness and myocardial dysfunction worsen rapidly in CA patients. However, the weak correlation between PWV and GLS suggests that they may evolve through independent mechanisms, necessitating further research to understand their complex interplay in CA.
心脏淀粉样变性（CA）是一种进行性疾病，其特征是淀粉样纤维沉积于心脏，导致心力衰竭和心律失常。通过脉搏波速度（PWV）评估的动脉僵硬度被认为是淀粉样变性的不良后果，但其进展以及与心肌功能障碍的关系仍未得到充分研究。本研究在6个月的随访期内，考察了CA患者PWV的进展及其与整体纵向应变（GLS）恶化的潜在关联。这项前瞻性研究纳入了31例被诊断为CA的患者，包括免疫球蛋白轻链（AL）型和转甲状腺素蛋白（ATTR）型。所有参与者在基线和6个月随访时均接受了完整的超声心动图检查和PWV测量（颈股 [c-f] 和颈桡 [c-r] PWV）。将具有相似心血管危险因素的年龄和性别匹配个体作为对照组。在CA组中，左心室质量指数（LVMI）从119.4±52.1显著增加至124±53.2 g/m²（P = 0.002）。在6个月随访时，c-f和c-r PWV均显著增加（分别为P < 0.001和P = 0.005）。GLS从-14±4.4%显著恶化至-12.8±4.9%（P = 0.018）。对照组未观察到显著变化。PWV增加与GLS恶化之间存在弱相关性（r = 0.3；P = 0.095）。CA患者的动脉僵硬度和心肌功能障碍均迅速恶化。然而，PWV与GLS之间的弱相关性表明它们可能通过独立机制演变，需要进一步研究以了解它们在CA中的复杂相互作用。
