Shorter deceleration time by transesophageal compared to transthoracic echo: Different staging in cardiac amyloidosis

Christian S. Breburda*, Samir Kapadia, Joseph Pietrolungo, James D. Thomas, Allan L. Klein

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

The diagnostic role of transesophageal echo in cardiac amyloidosis is unknown. We performed pulsed Doppler of the pulmonary vein (PV) and mitral inflow with respiratory monitoring using sequential TTE and TEE in 31 pts (mean age 61±12 years, 23 males) with cardiac amyloidosis. We quantitated mitral inflow and PV flow by averaging 9 cardiac cycles. Patients were categorized into 3 stages: abnormal relaxation (AR), pseudonormalization (PN): or restriction (R) as previously ascribed. Results: Deceleration time was significantly shorter by TEE compared to TTE: 151 ± 39 ms versus 132 ± 41 ms by TEE, mean difference of -19 ± 21ms (p<0.001, r2= 0.74, see graphs). (Figure Presented) Agreement of staging was fair (kappa= 0.41, p=0.005): TEE upgraded 75% (n=3) of the TTE AR pts and all pts (n=7) of the TTE PN group. PV flow was not visualized in 11 pt (33%) by TTE. Conclusions: 1. DT is shorter by TEE vs TTE, which results from better profile delineation by TEE. 2. TEE staging of diastolic dysfunction in cardiac amyloidosis differs from TTE. 3. Use of TEE for staging of cardiac amyloidosis could influence prognosis, especially in early and intermediate stages of diastolic dysfunction.

Original languageEnglish (US)
Number of pages1
JournalJournal of the American Society of Echocardiography
Volume10
Issue number4
StatePublished - Dec 1 1997

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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