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Case Report: Contrast adenosine stress echocardiography revealing microvascular dysfunction in cardiac AL amyloidosis

Year: 2026

Type: article

Abstract: Cardiac amyloidosis (CA) is a rare but increasingly recognized cause of restrictive cardiomyopathy. Noninvasive assessment of coronary microvascular dysfunction in CA can facilitate earlier diagnosis and improve disease monitoring. We present a case of light-chain (AL) cardiac amyloidosis manifesting as exertional angina with non-obstructive epicardial coronary arteries, in which contrast adenosine stress echocardiography combined with Doppler-derived coronary flow velocity reserve (CFVR) measurement revealed impaired myocardial perfusion and reduced CFVR. The findings were consistent with cardiac magnetic resonance (CMR) and laboratory results, confirming the diagnosis of CA. This case demonstrates the clinical application of contrast adenosine stress echocardiography as a practical adjunct to advanced imaging modalities for evaluating microvascular dysfunction in CA.

Source: Frontiers in Cardiovascular Medicine

DOI: 10.3389/fcvm.2026.1710211

Authors: Yuqian Dai, Yan Deng, Ni Lin, Feifei Che, Chunmei Li, Lixue Yin

Institutions: St. George's University, University of Electronic Science and Technology of China, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital

Language: English

Topic: Amyloidosis: Diagnosis, Treatment, Outcomes

Subfield: Molecular Biology

Field: Biochemistry, Genetics and Molecular Biology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801