| Objective:1.Analyze the clinical data of 22 patients diagnosed with myocardial amyloidosis by pathological biopsy from January 1,2010 to December 31,2020 in the First Hospital of Jilin University.2.Analyze the impact of laboratory indicators and cardiac color Doppler ultrasound on survival timeMethod:A retrospective analysis of the clinical data of 22 patients with myocardial amyloidosis diagnosed by pathological biopsy in the First Hospital of Jilin University from January 1,2010 to December 31,2020,and analyze the clinical manifestations and electrocardiogram(ECG),Cardiac color ultrasound(UCG)and cardiac magnetic resonance(CMR)characteristics.Result:1.Among the selected patients,13 were males(59%)and 9 were females(41%),with an average age of 58.05±12.703 years.There were6 cases with hypertension,1 case with diabetes,and 3 cases with myeloma.2.Among the admission symptoms,11 cases of dyspnea(50%),11 cases of chest tightness(50%),4 cases of lower extremity edema(18.2%),4 cases of palpitations(18.2%),1 case of nausea(4.5%),and 1 case of dizziness Cases(4.5%).Twenty patients(90.9%)were rated III-IV in cardiac function.3.Hematological examination LDH increased in 3 cases(13.6%),TBIL increased in 4 cases(18.2%),DBIL increased in 5 cases(22.7%),IBIL increased in 3 cases(13.6%),AST increased in 6 cases(27.3)%),ALT increased in 5 cases(22.7%),γ-GT increased in 13 cases(59%),blood LAMDA chain increased in 5 cases(22.7%),blood free κ chain increased in 6 cases(27.3%),13 cases(59%)of blood free lambda chain increased,10 cases(45.5%)of urine KAPPA chain increased,8 cases(36.4%)of urine LAMDA chain,10 cases(45.5%)of urine protein ≥0.2g/24 hours).4.ST-T changes in 6 cases(27.3%),limb lead low voltage in 8 cases(36.4%),atrial fibrillation in 4 cases(18.2%),atrial flutter in 1 case(4.5%),complete left bundle branch conduction Block 2 cases(9%),left anterior branch block in 4 cases(18.2%),complete right bundle branch block in 3 cases(13.6%),1 degree atrioventricular block in 2 cases(9%),One case of sinus bradycardia(4.5%),two cases(9%)of old anterior myocardial infarction,one case of type B pre-excitation syndrome(4.5%),and 4 cases(18.2%)of poor R wave progression.5.3 cases of severe tricuspid regurgitation(13.6%),20 cases of decreased left ventricular diastolic function(90.9%),18 cases of pericardial effusion(81.8%),18 cases of left ventricular wall thickening(72%),double 11 cases(44%)had room enlargement,and 10 cases(45.5%)had left ventricular ejection fraction less than 50%.6.Kaplan-meier analyzed the impact of low voltage in limb leads,cardiac color Doppler ultrasound results,c Tn I,NT-pro BNP,chemotherapy,etc.on the survival time of patients,and found that the median survival time with low voltage in limb leads was 14 months,and there was no limb lead.The median survival time of patients with combined low voltage is 48 months(p=0.027),and the other p>0.05 is of little significance.7.Univariate cox analysis of patients’ limb lead low voltage,c Tn I,NT-pro BNP,chemotherapy,etc.are related to the patient’s survival time,and it is found that c Tn I(p=0.039)and limb lead low voltage(p=0.042)are related to the patient’s survival time.Conclusion:1.CA is more common in elderly men with atypical clinical symptoms.Low voltage in the limb leads of ECG is more common.Cardiac color Doppler ultrasound often shows diastolic dysfunction,left ventricular wall thickening,pericardial effusion,and delayed gadolinium enhancement in myocardial MRI.2.The patient’s survival time is related to c Tn I and low voltage in the limb leads.The appearance of low voltage in the limb leads on the ECG indicates a poor prognosis. |
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