Cardiac Imaging

Echo Clues: When to Suspect Amyloidosis

cardiac amyloidosis echo

Aortic stenosis and cardiac amyloidosis cause similar functional and morphological changes in the heart, and discerning between the two conditions can be difficult. But in this European Heart Journal meta-analysis, researchers brought to light key differences in a large number of conventional echo criteria that can predict the presence of cardiac amyloidosis (CA) in aortic stenosis (AS) patients. 

The authors reviewed observational data from 1,449 patients (160 AS-CA and 1,289 AS-only) and found that the following features were significantly higher in patients with AS-CA compared with AS-only patients:

  • interventricular septal thickness (standardized mean difference: 0.74)
  • relative wall thickness (SMD: 0.74) 
  • posterior wall thickness (SMD: 0.74
  • LV mass index (SMD: 1.62)
  • E/A ratio (SMD: 4.18)
  • LA dimension (SMD: 0.73)

In contrast, these attributes were significantly lower in AS-CA patients:

  • myocardial contraction fraction (SMD: −2.88)
  • average mitral annular S′ (SMD: −1.14)
  • tricuspid annular plane systolic excursion (SMD: −0.36)
  • tricuspid annular S′ (SMD: −0.77)

The Takeaway

As the study’s editorial put it, the authors have revealed a “fundamental principle.” Routine echocardiographic parameters may prove to be “the key” to spotting cardiac amyloidosis in the presence of aortic stenosis. 

Get twice-weekly insights on the biggest stories shaping cardiology.

You might also like

Electrophysiology August 21, 2025

Conduction-System Pacing Succeeds at Treating AV Block August 21, 2025

Conduction-system pacing could be poised to reshape standard care for atrioventricular (AV) block patients after the randomized CSPACE trial demonstrated its significant benefits over traditional right ventricular septal pacing. Taking a closer look at CSP’s potential, the CSPACE trial enrolled 202 patients with AV block at two Australian hospitals, randomizing them to conduction-system pacing or […]

Cardiology Pharmaceuticals August 18, 2025

Rivaroxaban Monotherapy Could Be Better for CAD + AFib August 18, 2025

New analysis from the AFIRE trial suggests rivaroxaban monotherapy might be emerging as a preferred antithrombotic strategy for patients with AFib and stable coronary artery disease, especially in older age groups. The Post Hoc AFIRE Analysis examined 2,215 Japanese patients with AFib and stable CAD, stratifying them into four age groups (<70, 70-74, 75-79, and […]

Surgeries & Interventions August 14, 2025

TEER Could Save Lives in AFMR Patients August 14, 2025

Shedding light on a new treatment for an understudied condition, data published in EHJ suggests that transcatheter edge-to-edge repair (TEER) delivers significant survival advantages in patients with atrial functional mitral regurgitation (FMR). The new OCEAN-Mitral/REVEAL-AFMR Analysis compared 441 TEER-treated patients against 640 medically managed controls with moderate or severe atrial FMR, stating a solid case […]

This content is exclusive to subscribers

Log in or join by entering your email below.

Completely free. Every Monday and Thursday.

CW Phone Square

You might also like..

Select All

You're signed up!

It's great to have you as a reader. Check your inbox for a welcome email.

-- The Cardiac Wire Team

You're all set!