{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:49:32Z","timestamp":1753876172865,"version":"3.41.2"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T00:00:00Z","timestamp":1653955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Cardiac amyloidosis (CA) is a rapidly progressive infiltrative cardiomyopathy, whose role is emerging as a not-so-rare disorder leading to heart failure (HF). Myocardial bridge (MB) is the most common inborn coronary artery variant, and its clinical relevance is still matter of debate. The exceptional coexistence of these two conditions could accelerate disease progression and worsen the already compromised clinical conditions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We present the case of a 76-year-old female patient experiencing relapsing HF decompensation and presenting to our centre with dyspnoea at rest and severe peripheral congestion. Echocardiogram showed severe concentric hypertrophy, severe biventricular contractile dysfunction, and third-degree diastolic dysfunction. Coronary angiography excluded epicardial atherosclerotic disease, though displaying a long intramyocardial course of left anterior descending artery. Physiological invasive test was achieved in terms of instantaneous wave-free ratio (iFR), both at baseline and after inotropic and chronotropic stimuli, and attested haemodynamic significance. Concurrently, the diagnostic flow chart for CA was accomplished, by means of both invasive (periumbilical fat biopsy, bone marrow aspiration) and non-invasive tests (99mTc-diphosphonate scintigraphy, serum-urine immunofixation) that confirmed the suspect of primary amyloidosis. Acute HF therapy was personalized according to the singularity of the case, avoiding both nitrates and beta-blockers, then first cycle of chemotherapy was started.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Our clinical case shows a unique interaction between infiltrative cardiomyopathy and coronary artery abnormality. Amyloidosis can contribute to the ischaemic burden of the MB and this may, in turn, abbreviate the path to HF decompensation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac225","type":"journal-article","created":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T23:12:00Z","timestamp":1654038720000},"source":"Crossref","is-referenced-by-count":3,"title":["\u2018Here comes the story of the Hurricane\u2019: a case report of AL cardiac amyloidosis and myocardial bridging"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6905-9268","authenticated-orcid":false,"given":"Luigi","family":"Cappannoli","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Sciences, Catholic University of the Sacred Heart (UCSC) , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Ciliberti","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, Catholic University of the Sacred Heart (UCSC) , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9097-5287","authenticated-orcid":false,"given":"Attilio","family":"Restivo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, Catholic University of the Sacred Heart (UCSC) , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1514-0092","authenticated-orcid":false,"given":"Pierpaolo","family":"Palumbo","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, area of Cardiovascular and Interventional Imaging, Abruzzo Health Unit 1 , L'Aquila , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3576-8522","authenticated-orcid":false,"given":"Francesco","family":"D\u2019Al\u00f2","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tommaso","family":"Sanna","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9404-8846","authenticated-orcid":false,"given":"Filippo","family":"Crea","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, Catholic University of the Sacred Heart (UCSC) , Rome , Italy"},{"name":"Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3774-8330","authenticated-orcid":false,"given":"Domenico","family":"D\u2019Amario","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, Catholic University of the Sacred Heart (UCSC) , Rome , Italy"},{"name":"Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,5,31]]},"reference":[{"key":"2024051617570831100_ytac225-B1","first-page":"2563","article-title":"Free light chains a novel biomarker of cardiovascular disease. A pilot study","volume":"23","author":"Basile","year":"2019","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"2024051617570831100_ytac225-B2","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 College Cardiol"},{"key":"2024051617570831100_ytac225-B3","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1093\/eurheartj\/ehab072","article-title":"Diagnosis and treatment of cardiac amyloidosis: a position statement of the ESC Working Group on Myocardial and Pericardial Diseases","volume":"42","author":"Garcia-Pavia","year":"2021","journal-title":"Eur Heart J"},{"key":"2024051617570831100_ytac225-B4","first-page":"521","article-title":"Myocardial bridging: an up-to-date review","volume":"27","author":"Lee","year":"2015","journal-title":"J Invasive Cardiol"},{"key":"2024051617570831100_ytac225-B5","article-title":"\u201cA bridge over troubled water\u201d: a case report","volume":"5","author":"D\u2019amario","year":"2021","journal-title":"Eur Hear J Case Rep"},{"key":"2024051617570831100_ytac225-B6","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1016\/j.hoc.2020.08.004","article-title":"Systemic amyloidosis caused by monoclonal immunoglobulins: soft tissue and vascular involvement","volume":"34","author":"Hoffman","year":"2020","journal-title":"Hematol\/Oncol Clin North Am"},{"key":"2024051617570831100_ytac225-B7","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1001\/jama.2020.5493","article-title":"Systemic amyloidosis recognition, prognosis, and therapy: a systematic review","volume":"324","author":"Gertz","year":"2020","journal-title":"JAMA"},{"key":"2024051617570831100_ytac225-B8","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1186\/s12872-018-0952-8","article-title":"Diagnosis of cardiac amyloidosis: a systematic review on the role of imaging and biomarkers","volume":"18","author":"Kyriakou","year":"2018","journal-title":"BMC Cardiovasc Disord"},{"key":"2024051617570831100_ytac225-B9","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1093\/eurheartj\/ehm066","article-title":"Vascular abnormalities in primary amyloidosis","volume":"8","author":"Modesto","year":"2007","journal-title":"Eur Heart J"},{"key":"2024051617570831100_ytac225-B10","first-page":"358","article-title":"Coronary microvascular dysfunction is related to abnormalities in myocardial structure and function in cardiac amyloidosis","volume-title":"JACC Hear Fail","author":"Dorbala","year":"2014"},{"key":"2024051617570831100_ytac225-B11","doi-asserted-by":"crossref","first-page":"2418","DOI":"10.1161\/CIRCULATIONAHA.106.657023","article-title":"Evidence for microvascular dysfunction in hypertrophic cardiomyopathy new insights from multiparametric magnetic resonance imaging","volume":"115","author":"Petersen","year":"2007","journal-title":"Circulation"},{"key":"2024051617570831100_ytac225-B12","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s12968-016-0223-8","article-title":"Microvascular ischemia in hypertrophic cardiomyopathy: new insights from high-resolution combined quantification of perfusion and late gadolinium enhancement","volume":"18","author":"Villa","year":"2015","journal-title":"J Cardiovasc Magn Reson"},{"key":"2024051617570831100_ytac225-B13","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1016\/j.carrev.2020.02.014","article-title":"An updated review on myocardial bridging","volume":"21","author":"Murtaza","year":"2020","journal-title":"Cardiovasc Revasc Med"},{"key":"2024051617570831100_ytac225-B14","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.4244\/EIJ-D-18-00920","article-title":"Prevalence of myocardial bridging associated with coronary endothelial dysfunction in patients with chest pain and non-obstructive coronary artery disease","volume":"15","author":"Sara","year":"2020","journal-title":"EuroIntervention"},{"key":"2024051617570831100_ytac225-B15","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1161\/01.ATV.15.1.2","article-title":"Expression of ICAM-1 and VCAM1 and monocyte adherence in arteries exposed to altered shear stress","volume":"15","author":"Walpola","year":"1995","journal-title":"Aterioscler Thromb Vasc Biol"},{"key":"2024051617570831100_ytac225-B16","doi-asserted-by":"crossref","first-page":"H2290","DOI":"10.1152\/ajpheart.00515.2003","article-title":"Role of xanthine oxidoreductase and NAD(P)H oxidase in endothelial superoxide production in response to oscillatory shear stress","volume":"285","author":"McNally","year":"2003","journal-title":"Am J Physiol Hear Circ Physiol"},{"key":"2024051617570831100_ytac225-B17","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1007\/s10554-018-1460-8","article-title":"Myocardial bridging of the left anterior descending coronary artery is associated with reduced myocardial perfusion reserve: a 13N-ammonia PET study","volume":"35","author":"Monroy-Gonzalez","year":"2019","journal-title":"Int J Cardiovasc Imaging"},{"key":"2024051617570831100_ytac225-B18","doi-asserted-by":"crossref","first-page":"e006247","DOI":"10.1161\/CIRCINTERVENTIONS.117.006247","article-title":"Unmasking myocardial bridge-related ischemia by intracoronary functional evaluation","volume":"11","author":"Tarantini","year":"2018","journal-title":"Circ Cardiovasc Interv"},{"key":"2024051617570831100_ytac225-B19","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.15252\/emmm.201404190","article-title":"Lysosomal dysfunction and impaired autophagy underlie the pathogenesis of amyloidogenic light chain-mediated cardiotoxicity","volume":"6","author":"Guan","year":"2014","journal-title":"EMBO Mol Med"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytac225\/43894811\/ytac225.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/7\/ytac225\/57707979\/ytac225.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/7\/ytac225\/57707979\/ytac225.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T18:01:58Z","timestamp":1715882518000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytac225\/6595613"}},"subtitle":[],"editor":[{"given":"Davide","family":"Stolfo","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Giacomo Tini","family":"Melato","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Devika","family":"Kir","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Luca","family":"Arcari","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Megha","family":"Agarwal","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Mariame","family":"Chakir","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,5,31]]},"references-count":19,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,7,6]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytac225","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2022,7,1]]},"published":{"date-parts":[[2022,5,31]]},"article-number":"ytac225"}}