{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:57:51Z","timestamp":1792684671053,"version":"4.5.0"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,9,17]]},"abstract":"\n Background<\/jats:title>\n \n The relationship between structural pathology and electrophysiological substrate in cardiac amyloidosis is unclear. Differences between light\u2010chain (\n AL<\/jats:styled-content>\n ) and transthyretin (\n ATTR<\/jats:styled-content>\n ) cardiac amyloidosis may have prognostic implications.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n ECG<\/jats:styled-content>\n imaging and cardiac magnetic resonance studies were conducted in 21 cardiac amyloidosis patients (11\n AL<\/jats:styled-content>\n and 10\n ATTR<\/jats:styled-content>\n ). Healthy volunteers were included as controls. With respect to\n ATTR<\/jats:styled-content>\n ,\n AL<\/jats:styled-content>\n patients had lower amyloid volume (51.0\/37.7 versus 73.7\/16.4\u00a0mL,\n P<\/jats:italic>\n =0.04), lower myocardial cell volume (42.6\/19.1 versus 58.5\/17.2\u00a0mL,\n P<\/jats:italic>\n =0.021), and higher T1 (1172\/64 versus 1109\/80\u00a0ms,\n P<\/jats:italic>\n =0.022) and T2 (53.4\/2.9 versus 50.0\/3.1\u00a0ms,\n P<\/jats:italic>\n =0.003).\n ECG<\/jats:styled-content>\n imaging revealed differences between cardiac amyloidosis and control patients in virtually all conduction\u2010repolarization parameters. With respect to\n ATTR<\/jats:styled-content>\n ,\n AL<\/jats:styled-content>\n patients had lower epicardial signal amplitude (1.07\/0.46 versus 1.83\/1.26\u00a0mV,\n P<\/jats:italic>\n =0.026), greater epicardial signal fractionation (\n P<\/jats:italic>\n =0.019), and slightly higher dispersion of repolarization (187.6\/65 versus 158.3\/40\u00a0ms,\n P<\/jats:italic>\n =0.062). No significant difference between\n AL<\/jats:styled-content>\n and\n ATTR<\/jats:styled-content>\n patients was found using the standard 12\u2010lead\n ECG<\/jats:styled-content>\n . T1 correlated with epicardial signal amplitude (cc=\u22120.78), and extracellular volume with epicardial signal fractionation (cc=0.48) and repolarization time (cc=0.43). Univariate models based on single features from both cardiac magnetic resonance and\n ECG<\/jats:styled-content>\n imaging classified\n AL<\/jats:styled-content>\n and\n ATTR<\/jats:styled-content>\n patients with an accuracy of 70% to 80%.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In this exploratory study cardiac amyloidosis was associated with ventricular conduction and repolarization abnormalities, which were more pronounced in\n AL<\/jats:styled-content>\n than in\n ATTR<\/jats:styled-content>\n . Combined\n ECG<\/jats:styled-content>\n imaging\u2013cardiac magnetic resonance analysis supports the hypothesis that additional mechanisms beyond infiltration may contribute to myocardial damage in\n AL<\/jats:styled-content>\n amyloidosis. Further studies are needed to assess the clinical impact of this approach.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.012097","type":"journal-article","created":{"date-parts":[[2019,9,8]],"date-time":"2019-09-08T22:55:11Z","timestamp":1567983311000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":40,"title":["Noninvasive Mapping of the Electrophysiological Substrate in Cardiac Amyloidosis and Its Relationship to Structural Abnormalities"],"prefix":"10.1161","volume":"8","author":[{"given":"Michele","family":"Orini","sequence":"first","affiliation":[{"name":"Barts Heart Centre Barts Health NHS Trust London United Kingdom"},{"name":"Institute of Cardiovascular Science University College London London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Graham","sequence":"additional","affiliation":[{"name":"Barts Heart Centre Barts Health NHS Trust London United 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