Coexistence of aortic valve stenosis and cardiac amyloidosis: Echocardiographic and clinical significance

Gergely Peskó, Zsigmond Jenei, Gergely Varga, Astrid Apor, Hajnalka Vágó, Sándor Czibor, Zoltán Prohászka, Tamás Masszi, Zoltán Pozsonyi

Research output: Contribution to journalArticle


Background: Left ventricular hypertrophy and diastolic dysfunction are common echocardiographic features of both aortic valve stenosis (AS) and cardiac amyloidosis (CA). These two different entities therefore may mask each other. From recent years, there is a growing body of evidence about the relatively high incidence of wild-type transthyretin (wtTTR) amyloidosis in AS, but there are scarce data on the prevalence of AS in CA, particularly in AL-type amyloidosis. The echocardiographic approach to these patients is not obvious, and not evidence based. We aimed to study the prevalence, severity, and type of AS in patients with CA and also to evaluate the potential of echocardiography in the diagnostic process. Methods: Between January 2009 and January 2019, we retrospectively analyzed the clinical and echocardiographic data, and the echocardiographic work up of 55 consecutive CA patients. Results: 80% of our CA patients had AL amyloidosis. We identified 5 patients (9%) with moderate to severe AS: two with moderate AS and three with low-flow, low-grade AS (LFLG AS). Further analysis of the latter three patients with dobutamine stress echocardiography revealed pseudo-severe LFLG AS in two, and true-severe AS in one patient. Conclusion: The prevalence of moderate to severe AS is 9% in our population of CA patients, the majority of whom have AL amyloidosis. Dobutamine echocardiography seems to be appropriate for the further characterization of patients with LFLG AS, even with normal ejection fraction.

Original languageEnglish
Article number32
JournalCardiovascular Ultrasound
Issue number1
Publication statusPublished - Dec 26 2019


  • Aortic valve stenosis
  • Cardiac amyloidosis
  • Dobutamine stress echo

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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