What is the prognosis of cardiac amyloidosis?

Updated: Mar 25, 2020
  • Author: Gyanendra K Sharma, MD, FACC, FASE; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

In general, cardiac involvement is a marker of poor prognosis. [26, 27] Therefore, any clinical, laboratory or imaging abnormality that suggests increased cardiac involvement will be indicative of a worse prognosis. No consensus has been reached about a single most important prognostic factor. The factors associated with a poor prognosis include the following:

  • Syncope

  • Complex arrhythmia

  • Degree of left ventricular (LV) hypertrophy (More = worse prognosis)

  • Low LV ejection fraction (LVEF)

  • Restrictive hemodynamic

  • Right ventricular dilatation

  • Pulmonary hypertension

  • Low voltage on electrocardiography (ECG)

  • High brain natriuretic peptide (BNP) levels

  • High troponin levels

  • T1 kinetics on gadolinium-enhanced magnetic resonance imaging (MRI) (to demonstrate extent of myocardial involvement)


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