P79 Aortic Viscoelastic Properties and Altered Electromechanical Cardio-Aortic Connection in Patients with Cardiac Amyloidosis

Abstract

Background

Cardiac amyloidosis (CA) is an infiltrative disorder caused by deposition of amyloid fibrils in the myocardial extracellular matrix. A wide scientific literature regarding amyloid heart disease is available, but no data about aortic viscoelastic properties. This studio has the aims to start filling this gap.

Methods

129 outpatients attending the Pavia Amyloid Center were enrolled, 66 of them affected by cardiac amyloidosis. Arterial applanation tonometry (PulsePen, DiaTecne, Milan, Italy) was performed to calculate carotid-to-femoral pulse wave velocity (PWV) as index of aortic stiffness. Carotid pressure wave was calibrated with oscillometric brachial blood pressure (BP) to obtain central BP, pulse pressure amplification (PPA) and augmentation index (Aix). Tonometric data were related to biochemical parameters, clinical data and treatment. Populations with and without cardiac involvement (NCA) were compared.

Results

There is no difference in Carotid-femoral PWV in the two groups (p = 0,749), PPA was significantly reduced in CA subjects (p = 0,0010). CA subjects had lower both peripheral pressure values and central ones. No significant differences in central pulse pressure (p = 0,684), and Aix (p = 0,1518) were found Heart rate is significantly higher in CA (p = 0,0010). In these patients, isovolumic contraction time is prolonged (p = 0.0120), and the ejective period is reduced (p < 0.0001).

Conclusions

Amyloid cardiopathy strongly impairs cardiac function without significantly alteration in aortic function. In other words, in CA there is an altered electromechanical cardio-aortic connection, with preserved aortic properties. Significantly reduced central and peripheral pressure values could be caused by the inability of the heart to develop a proper post load.