A Clinical Analysis Of 268 Cases Of Cardiac Amyloidosis: A Literature Review (2001 To 2009)

Objective: To comprehend the clinical characteristics and treatment of present status of cardiac amyloidosis.Methods: Literatures on cardiac amyloidosis published in journals between January 2000 and October 2009 were identified by searching Chinese full text database of CNKI and wanfang, English full text database of pubmed and FMJS. Retrospective review items include: clinical manifestation, assistance examination, misdiagnosis, treatment and prognosis, the cause of death and so on.Results: (1) A total of 44 literatures with 268 cardiac amyloidosis patients were found. (2) Cardiac amyloidosis occurred in any age, especially the elder. The male incidence rate was higher than female obviously(2.67:1). (3) The most common clinical manifestation was progressivily congestive heart failure(67.1%), such as edema of lower extremity(54.3%), dyspnea(44.51%), hepatomegaly (39.0%) and distention of jugular vein (34.8%). Another common symptom was chest pain(25.6%). Out of cardiovascular system, kidney(37.2%) was the mostly affected organ, such as proteinuria (29.8%). (4) Cardiac amyloidosis was fallibility misdiagnosed multiple diseases, the most common were hypertrophic cardiomyopathy (58.9%) and restrictive cardiomyopathy(28.8%). The final diagnostic method was Endomyocardial biopsy (EMB). The important assistance examinations were Electrocardiogram (ECG), echocardiogram and cardiovascular magnetic resonance imaging (CMRI). It is possible that CMRI becomes a new noninvasive diagnostic method. (5) The cases with congestive heart failure had a poor prognosis.Conclusions: The clinical manifestation of cardiac amyloidosis is multiple, and it is easy to misdiagnose for hypertrophic cardiomyopathy and restrictive cardiomyopathy. Cardiac amyloidosis has a poor prognosis, especially with congestive heart failure. It is essential to diagnose and treat as early as possible.