Left atrial size—Another Differentiator for Cardiac Amyloidosis

BackgroundThe “sparkled” echocardiographic appearance of amyloid has become less visually obvious in the era of harmonic imaging. Significantly dilated atria in the setting of a normal sized ventricle may be another easy visual marker for cardiac amyloidosis.MethodsA retrospective analysis of echocardiograms of patients with biopsy-proven cardiac amyloid compared with patients with hypertension was conducted. There were 36 patients in each group, and they were matched for left ventricular wall thickness, as well as age and sex.ResultsPatients with cardiac amyloid had significantly larger atria than the group with hypertension (left atrial areas 29 cm2 versus 19 cm2, p < 0.001, AUC 0.84, volumes 100 cm3 versus 55 cm3, p < 0.001, AUC 0.915). A volume of 69 cm3 produced a specificity and sensitivity of 85% for amyloidosis.ConclusionsAtrial dilatation can be used as a visual marker for cardiac amyloidosis. This may be a simple visual method to differentiate this infiltrative cardiomyopathy from left ventricular hypertrophy.