Clinical characteristics analysis of 39 patients with light chain cardiac amyloidosis
Objective:To analyze the clinical characteristics of 39 patients with light chain cardiac amyloidosis and identify factors that may affect their survival rate.Methods:39 patients with mild chain amyloidosis diagnosed by pathology and admitted to our hospital from December 2018 to December 2023 were divided into a 1-year death group and a survival group according to clinical characteristics.The differences between the two groups were analyzed to identify factors that may affect the 1-year survival rate of patients.Results:Among the 39 patients included in the study,routine electrocardiogram results mainly showed symptoms such as limb lead QRS low voltage and sinus arrhythmia;Echocardiography suggests symmetrical thickening of the left ventricular wall,mitral regurgitation(moderate to severe),and reduced left ventricular systolic and diastolic function;Among them,17 patients underwent cardiac magnetic resonance(CMR)examination,and the results showed significant thickening of the left ventricular wall and interventricular septum,narrowing of the ventricular cavity,and enlargement of both atria,consistent with changes in cardiac amyloidosis.The test results indicate that except for 2 patients with normal cTnT results,the cTnT results of the remaining patients have increased to varying degrees;The results of NT proBNP were all increased.Using binary logistic regression analysis,it was found that an increase in cTnT can indicate an increased risk of death within one year for patients.Pathological biopsy results indicate that all biopsy tissues were stained with Congo red under pathological light microscopy and appeared brick red.Conclusion:The clinical symptoms of light chain cardiac amyloidosis are atypical and prone to misdiagnosis.When patients present with heart failure,pericardial effusion is present,and the electrocardiogram shows low voltage in limb leads,echocardiography suggests thickening of the ventricular wall,blood sample examination shows increased concentrations of NT proBNP and cTnT,and pathological biopsy shows brick red staining,which helps to clarify the clinical diagnosis of cardiac amyloidosis.Patients with myocardial injury have an increased risk of death within one year.
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