{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T17:12:31Z","timestamp":1783098751792,"version":"3.54.6"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T00:00:00Z","timestamp":1659571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Aortic stenosis (AS) and cardiac amyloidosis (CA) frequently coexist but the diagnosis of CA in AS patients remains a diagnostic challenge. We aim to evaluate the echocardiographic parameters that may aid in the detection of the presence of CA in AS patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method and results<\/jats:title>\n                  <jats:p>We performed a systematic literature search of electronic databases for peer-reviewed articles from inception until 10 January 2022. Of the 1449 patients included, 160 patients had both AS\u2013CA whereas the remaining 1289 patients had AS-only. The result of our meta-analyses showed that interventricular septal thickness [standardized mean difference (SMD): 0.74, 95% CI: 0.36\u20131.12, P\u2009=\u20090.0001), relative wall thickness (SMD: 0.74, 95% CI: 0.17\u20131.30, P\u2009&amp;lt;\u20090.0001), posterior wall thickness (SMD: 0.74, 95% CI 0.51 to 0.97, P\u2009=\u20090.0011), LV mass index (SMD: 1.62, 95% CI: 0.63\u20132.62, P\u2009=\u20090.0014), E\/A ratio (SMD: 4.18, 95% CI: 1.91\u20136.46, P\u2009=\u20090.0003), and LA dimension (SMD: 0.73, 95% CI: 0.43\u20131.02, P\u2009&amp;lt;\u20090.0001)] were found to be significantly higher in patients with AS\u2013CA as compared with AS-only patients. In contrast, myocardial contraction fraction (SMD: \u22122.88, 95% CI: \u22125.70 to \u22120.06, P\u2009=\u20090.045), average mitral annular S\u2032 (SMD: \u22121.14, 95% CI: \u22121.86 to \u22120.43, P\u2009=\u20090.0017), tricuspid annular plane systolic excursion (SMD: \u22120.36, 95% CI: \u22120.62 to \u22120.09, P\u2009=\u20090.0081), and tricuspid annular S\u2032 (SMD: \u22120.77, 95% CI: \u22121.13 to \u22120.42, P\u2009&amp;lt;\u20090.0001) were found to be significantly lower in AS\u2013CA patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Parameters based on echocardiography showed great promise in detecting CA in patients with AS. Further studies should explore the optimal cut-offs for these echocardiographic variables for better diagnostic accuracy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jeac146","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T15:40:57Z","timestamp":1659627657000},"page":"1290-1301","source":"Crossref","is-referenced-by-count":22,"title":["Echocardiographic predictors of presence of cardiac amyloidosis in aortic stenosis"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2021-1660","authenticated-orcid":false,"given":"Vikash","family":"Jaiswal","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Research, Larkin Community Hospital , South Miami, FL 33143 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song Peng","family":"Ang","sequence":"additional","affiliation":[{"name":"School of Medicine, International Medical University , Tawau 91000 , Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia Ee","family":"Chia","sequence":"additional","affiliation":[{"name":"School of Medicine, International Medical University , Tawau 91000 , Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman Muhammad","family":"Abdelazem","sequence":"additional","affiliation":[{"name":"Analytical Biosciences and Metabolomics, Leiden University , Leiden 2333 , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akash","family":"Jaiswal","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, All India Institute of Medical Science , New Delhi 110029 , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monodeep","family":"Biswas","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Penn Medicine Lancaster General Health , Landisville, PA 17538 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3378-1723","authenticated-orcid":false,"given":"Alessia","family":"Gimelli","sequence":"additional","affiliation":[{"name":"Department of Imaging, Fondazione Toscana\/CNR Gabriele Monasterio , Pisa 56124 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Purvi","family":"Parwani","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Loma Linda University Health , Loma Linda, CA 92350 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanta M","family":"Siller-Matula","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical University of Vienna , Vienna 1090 , Austria"},{"name":"Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Center for Preclinical Research and Technology CEPT , Warsaw 02-091 , Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamas A","family":"Mamas","sequence":"additional","affiliation":[{"name":"Keele Cardiovascular Research Group, Keele University , Keele ST5 5BG , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,8,4]]},"reference":[{"key":"2022091014191464000_jeac146-B1","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.1016\/j.jcmg.2020.05.029","article-title":"Identifying cardiac amyloid in aortic stenosis: ECV quantification by CT in TAVR patients","volume":"13","author":"Scully","year":"2020","journal-title":"JACC Cardiovasc Imaging"},{"key":"2022091014191464000_jeac146-B2","doi-asserted-by":"crossref","first-page":"3525","DOI":"10.1093\/eurheartj\/ehw033","article-title":"Aortic stenosis and transthyretin cardiac amyloidosis: the chicken or the egg?","volume":"37","author":"Galat","year":"2016","journal-title":"Eur Heart J"},{"key":"2022091014191464000_jeac146-B3","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.1002\/ejhf.1756","article-title":"Light-chain and transthyretin cardiac amyloidosis in severe aortic stenosis: prevalence, screening possibilities, and outcome","volume":"22","author":"Nitsche","year":"2020","journal-title":"Eur J Heart Fail"},{"key":"2022091014191464000_jeac146-B4","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1136\/heartjnl-2021-319922","article-title":"Impact of afterload and infiltration on coexisting aortic stenosis and transthyretin amyloidosis","volume":"108","author":"Patel","year":"2022","journal-title":"Heart"},{"key":"2022091014191464000_jeac146-B5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12947-019-0182-y","article-title":"Coexistence of aortic valve stenosis and cardiac amyloidosis: echocardiographic and clinical significance","volume":"17","author":"Pesk\u00f3","year":"2019","journal-title":"Cardiovasc Ultrasound"},{"key":"2022091014191464000_jeac146-B6","doi-asserted-by":"crossref","first-page":"2879","DOI":"10.1093\/eurheartj\/ehx350","article-title":"Unveiling transthyretin cardiac amyloidosis and its predictors among elderly patients with severe aortic stenosis undergoing transcatheter aortic valve replacement","volume":"38","author":"Casta\u00f1o","year":"2017","journal-title":"Eur Heart J"},{"key":"2022091014191464000_jeac146-B7","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.hjc.2021.11.001","article-title":"Prevalence and outcomes of concomitant cardiac amyloidosis and aortic stenosis: a systematic review and meta-analysis","volume":"64","author":"Ho","year":"2022","journal-title":"Hellenic J Cardiol"},{"key":"2022091014191464000_jeac146-B8","doi-asserted-by":"crossref","first-page":"2851","DOI":"10.1016\/j.jacc.2020.04.022","article-title":"Cardiac scintigraphy with technetium-99m-labeled bone-seeking tracers for suspected amyloidosis: JACC review topic of the week","volume":"75","author":"Hanna","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2022091014191464000_jeac146-B9","first-page":"e72","article-title":"2020 ACC\/AHA guideline for the management of patients with valvular heart disease: a report of the American college of cardiology\/American heart association joint committee on clinical practice guidelines","volume":"143","author":"Otto","year":"2021","journal-title":"Circulation"},{"key":"2022091014191464000_jeac146-B10","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Stat Med"},{"key":"2022091014191464000_jeac146-B11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0000841","article-title":"Heterogeneity in meta-analyses of genome-wide association investigations","volume":"2","author":"Ioannidis","year":"2007","journal-title":"PLoS One"},{"key":"2022091014191464000_jeac146-B12","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"Bmj"},{"key":"2022091014191464000_jeac146-B13","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1002\/jrsm.12","article-title":"A basic introduction to fixed-effect and random-effects models for meta-analysis","volume":"1","author":"Borenstein","year":"2010","journal-title":"Res Synth Methods"},{"key":"2022091014191464000_jeac146-B14","volume-title":"The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses","author":"Wells","year":"2000"},{"key":"2022091014191464000_jeac146-B15","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1002\/ejhf.1974","article-title":"Unveiling outcomes in coexisting severe aortic stenosis and transthyretin cardiac amyloidosis","volume":"23","author":"Rosenblum","year":"2021","journal-title":"Eur J Heart Fail"},{"key":"2022091014191464000_jeac146-B16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12968-017-0415-x","article-title":"Cardiac amyloidosis is prevalent in older patients with aortic stenosis and carries worse prognosis","volume":"19","author":"Cavalcante","year":"2017","journal-title":"J Cardiovasc Magn Reson"},{"key":"2022091014191464000_jeac146-B17","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/j.jacc.2017.11.037","article-title":"Prevalence of cardiac amyloidosis in patients referred for transcatheter aortic valve replacement","volume":"71","author":"Scully","year":"2018","journal-title":"J Am Coll Cardiol"},{"issue":"Suppl. 3","key":"2022091014191464000_jeac146-B18","first-page":"A13456","article-title":"Abstract 13456: screening for transthyretin cardiac amyloidosis using 99mTc-pyrophosphate scintigraphy in patients undergoing transcatheter aortic valve replacement","volume":"132","author":"Narotsky","year":"2015","journal-title":"Circulation"},{"issue":"Suppl. 2","key":"2022091014191464000_jeac146-B19","first-page":"ehaa946","article-title":"Cardiac amyloidosis in patients undergoing aortic valve replacement for aortic stenosis","volume":"41","author":"Fukuzawa","year":"2020","journal-title":"Eur Heart J"},{"key":"2022091014191464000_jeac146-B20","doi-asserted-by":"crossref","first-page":"4234","DOI":"10.3390\/jcm10184234","article-title":"Aortic valve stenosis and cardiac amyloidosis: a misleading association","volume":"10","author":"Bonelli","year":"2021","journal-title":"J Clin Med"},{"key":"2022091014191464000_jeac146-B21","doi-asserted-by":"crossref","first-page":"e010356","DOI":"10.1161\/CIRCIMAGING.119.010356","article-title":"Usefulness of cardiac magnetic resonance imaging in aortic stenosis","volume":"13","author":"Bohbot","year":"2020","journal-title":"Circ Cardiovasc Imaging"},{"key":"2022091014191464000_jeac146-B22","doi-asserted-by":"crossref","first-page":"2888","DOI":"10.1093\/eurheartj\/ehx513","article-title":"Dangerous relationships: aortic stenosis and transthyretin cardiac amyloidosis","volume":"38","author":"Gargiulo","year":"2017","journal-title":"Eur Heart J"},{"key":"2022091014191464000_jeac146-B23","doi-asserted-by":"crossref","first-page":"2638","DOI":"10.1016\/j.jacc.2019.09.056","article-title":"Aortic stenosis and cardiac amyloidosis: JACC review topic of the week","volume":"74","author":"Ternacle","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2022091014191464000_jeac146-B24","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1016\/j.jacc.2016.06.053","article-title":"AL (Light-Chain) cardiac amyloidosis: a review of diagnosis and therapy","volume":"68","author":"Falk","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"2022091014191464000_jeac146-B25","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.jacc.2020.11.006","article-title":"Prevalence and outcomes of concomitant aortic stenosis and cardiac amyloidosis","volume":"77","author":"Nitsche","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2022091014191464000_jeac146-B26","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1021\/bi301313b","article-title":"Age-related oxidative modifications of transthyretin modulate its amyloidogenicity","volume":"52","author":"Zhao","year":"2013","journal-title":"Biochemistry"},{"key":"2022091014191464000_jeac146-B27","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1056\/NEJMoa1805689","article-title":"Tafamidis treatment for patients with transthyretin amyloid cardiomyopathy","volume":"379","author":"Maurer","year":"2018","journal-title":"N Engl J Med"},{"key":"2022091014191464000_jeac146-B28","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1002\/ejhf.2027","article-title":"Efficacy and safety of tafamidis doses in the tafamidis in transthyretin cardiomyopathy clinical trial (ATTR-ACT) and long-term extension study","volume":"23","author":"Damy","year":"2021","journal-title":"Eur J Heart Fail"},{"key":"2022091014191464000_jeac146-B29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1532-429X-14-50","article-title":"Left ventricular remodeling and hypertrophy in patients with aortic stenosis: insights from cardiovascular magnetic resonance","volume":"14","author":"Dweck","year":"2012","journal-title":"J Cardiovasc Magn Reson"},{"key":"2022091014191464000_jeac146-B30","first-page":"501","article-title":"Regional left ventricular deformation and geometry analysis provides insights in myocardial remodelling in mild to moderate hypertension","volume":"9","author":"Baltabaeva","year":"2008","journal-title":"Eur J Echocardiogr"},{"key":"2022091014191464000_jeac146-B31","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1016\/j.jcmg.2019.10.011","article-title":"Multiparametric echocardiography scores for the diagnosis of cardiac amyloidosis","volume":"13","author":"Boldrini","year":"2020","journal-title":"JACC Cardiovasc Imaging"},{"key":"2022091014191464000_jeac146-B32","doi-asserted-by":"crossref","first-page":"e13449","DOI":"10.1111\/eci.13449","article-title":"A simple echocardiographic score to rule out cardiac amyloidosis","volume":"51","author":"Aimo","year":"2021","journal-title":"Eur J Clin Invest"},{"key":"2022091014191464000_jeac146-B33","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/j.jcmg.2018.02.016","article-title":"Cardiac structural and functional consequences of amyloid deposition by cardiac magnetic resonance and echocardiography and their prognostic roles","volume":"12","author":"Knight","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"2022091014191464000_jeac146-B34","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1007\/s00059-015-4322-3","article-title":"Association between high-sensitivity troponin T, left ventricular hypertrophy, and myocardial performance index","volume":"40","author":"Kaypakli","year":"2015","journal-title":"Herz"},{"issue":"Suppl. 5","key":"2022091014191464000_jeac146-B35","first-page":"Iv73","article-title":"Diastolic dysfunction in aortic stenosis","volume":"87","author":"Hess","year":"1993","journal-title":"Circulation"},{"key":"2022091014191464000_jeac146-B36","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1136\/heartjnl-2017-311506","article-title":"The role and clinical implications of diastolic dysfunction in aortic stenosis","volume":"103","author":"Kampaktsis","year":"2017","journal-title":"Heart"},{"key":"2022091014191464000_jeac146-B37","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.jcmg.2021.06.022","article-title":"Clinical importance of left atrial infiltration in cardiac transthyretin amyloidosis","volume":"15","author":"Bandera","year":"2022","journal-title":"JACC Cardiovasc Imaging"},{"key":"2022091014191464000_jeac146-B38","doi-asserted-by":"crossref","first-page":"1442","DOI":"10.1136\/heartjnl-2012-302353","article-title":"Relative apical sparing of longitudinal strain using two-dimensional speckle-tracking echocardiography is both sensitive and specific for the diagnosis of cardiac amyloidosis","volume":"98","author":"Phelan","year":"2012","journal-title":"Heart"},{"key":"2022091014191464000_jeac146-B39","doi-asserted-by":"crossref","first-page":"ehaa946","DOI":"10.1093\/ehjci\/ehaa946.1987","article-title":"Relative apical sparing in patients with severe aortic stenosis: prevalence and significance","volume":"41","author":"Abecasis","year":"2020","journal-title":"Eur Heart J"},{"key":"2022091014191464000_jeac146-B40","doi-asserted-by":"crossref","first-page":"e005066","DOI":"10.1161\/CIRCIMAGING.116.005066","article-title":"Occult transthyretin cardiac amyloid in severe calcific aortic stenosis: prevalence and prognosis in patients undergoing surgical aortic valve replacement","volume":"9","author":"Treibel","year":"2016","journal-title":"Circ Cardiovasc Imaging"},{"key":"2022091014191464000_jeac146-B41","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1002\/9781119536604.ch10","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Deeks","year":"2019","edition":"2nd ed"}],"container-title":["European Heart Journal - Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/23\/10\/1290\/45786602\/jeac146.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/23\/10\/1290\/45786602\/jeac146.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,10]],"date-time":"2022-09-10T14:21:11Z","timestamp":1662819671000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article\/23\/10\/1290\/6655774"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,4]]},"references-count":41,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,8,4]]},"published-print":{"date-parts":[[2022,9,10]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjci\/jeac146","relation":{},"ISSN":["2047-2404","2047-2412"],"issn-type":[{"value":"2047-2404","type":"print"},{"value":"2047-2412","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,10,1]]},"published":{"date-parts":[[2022,8,4]]}}}