ArticleJACC. Case reports2026
Abnormal Cardiovascular Responses During Orthostatic Hypotension in Cardiac Amyloidosis Revealed by Semi-Sitting/Standing Stress Echocardiography.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMechanisms of orthostatic hypotension (OH) in cardiac amyloidosis (CA) patients remain largely unclarified. CASE SUMMARY: We performed semi-sitting/standing stress echocardiography in 6 healthy volunteers, 5 patients with CA but without OH [CA/OH(-)], and 4 with CA and OH [CA/OH(+)]. Semi-sitting/standing stress echocardiography revealed broad abnormal responses during semi-sitting/standing in CA/OH(+) patients, including reduced increase in heart rate, reduction in blood pressure, lack of reduction in left ventricular end-systolic dimension (contractile reserve), severely reduced stroke volume/cardiac output, paradoxical reduction in systemic vascular resistance, and paradoxical dilation of inferior vena cava dimension, compared to the group oh healthy volun. DISCUSSION: These findings may suggest a combined and broad abnormal compensations of all chronotropy, left ventricle, arteries, and veins during semi-sitting/standing, leading to severe OH with CA. TAKE-HOME MESSAGES: Broad cardiovascular abnormalities were observed in 4 patients with CA and OH. Semi-sitting/standing stress echocardiography may hold potential for exploring the underlying pathophysiological mechanisms.
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