Noninvasive Evaluation of Left Ventricular Systolic and Diastolic Time Intervals in Familial Amyloid Polyneuropathy
To determine left ventricular (LV) systolic and diastolic properties in patients with familial amyloid polyneuropathy (FAP), we analyzed simultaneous recordings of the electrocardiogram, phonocardiogram, carotid arterial pulse, and apex cardiogram (ACG) in 13 patients and 20 normal subjects. The following variables were measured: (1) LV systolic time intervals = iso-volumic contraction time (ICT), corrected preejection period (PEPi), corrected ejection time (ETi), corrected Q-I interval (Q-Ii), corrected Q-II interval (Q-IIi), PEP/ET, and ICT/ETi; (2) 1EA-O interval (IIA-O) = the time interval from the onset of the aortic component of the second heart sound to the 0 point on the ACG; (3) ΔT = the time interval from the onset of the aortic component of the second heart sound to the point on the ACG down-stroke where the curve falls to 50% of the total height of the diastolic deflection; and (4) ΔT/IIA-O. Patients with FAP had significantly greater Q-Ii, PEPi, Q-IIi, and PEP/ET than normal subjects, whereas there were no differences in the ETi, ICT, and ICT/ETi. Patients with FAP also showed slightly greater IIA-O than normal subjects but the difference was not significant. In addition, AT and AT/IIA-0 were significantly greater in patients with FAP than in normal subjects. We conclude that in patients with FAP, LV relaxation is impaired, especialy in early diastole, whereas systolic function is generally preserved, and that electromechanical delay is markedly increased.
KeywordsHeart Sound Heart Catheterization Alized Amyloidosis Early Diastole Systolic Time Interval
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