دورية أكاديمية
Defining echocardiographic predictors of outcome in cardiac amyloidosis by subtype.
| العنوان: | Defining echocardiographic predictors of outcome in cardiac amyloidosis by subtype. |
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| المؤلفون: | Singulane C; University of Chicago, Department of Medicine, Section of Cardiology, Chicago, IL, USA., Sun D; University of Chicago, Department of Medicine, Section of Cardiology, Chicago, IL, USA., Hu Z; University of Chicago, Department of Medicine, Section of Cardiology, Chicago, IL, USA., Lee L; University of Chicago, Department of Medicine, Section of Cardiology, Chicago, IL, USA., Sarswat N; University of Chicago, Department of Medicine, Section of Cardiology, Chicago, IL, USA., Emami Neyestanak M; University of Chicago, Department of Medicine, Section of Cardiology, Chicago, IL, USA., Patel AR; University of Chicago, Department of Medicine, Section of Cardiology, Chicago, IL, USA., Lang RM; University of Chicago, Department of Medicine, Section of Cardiology, Chicago, IL, USA., Addetia K; University of Chicago, Department of Medicine, Section of Cardiology, Chicago, IL, USA. Electronic address: kaddetia@bsd.uchicago.edu. |
| المصدر: | Current problems in cardiology [Curr Probl Cardiol] 2024 Sep; Vol. 49 (9), pp. 102729. Date of Electronic Publication: 2024 Jun 29. |
| نوع المنشور: | Journal Article; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 7701802 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1535-6280 (Electronic) Linking ISSN: 01462806 NLM ISO Abbreviation: Curr Probl Cardiol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: [Amsterdam] : Elsevier Original Publication: Chicago, Year Book Medical Publishers. |
| مواضيع طبية MeSH: | Cardiomyopathies*/physiopathology , Cardiomyopathies*/diagnosis , Cardiomyopathies*/diagnostic imaging , Immunoglobulin Light-chain Amyloidosis*/diagnosis , Immunoglobulin Light-chain Amyloidosis*/physiopathology , Immunoglobulin Light-chain Amyloidosis*/diagnostic imaging , Immunoglobulin Light-chain Amyloidosis*/mortality, Humans ; Male ; Female ; Aged ; Prognosis ; Echocardiography/methods ; Amyloid Neuropathies, Familial/diagnostic imaging ; Amyloid Neuropathies, Familial/physiopathology ; Amyloid Neuropathies, Familial/diagnosis ; Amyloid Neuropathies, Familial/mortality ; Retrospective Studies ; Middle Aged ; Aged, 80 and over ; Risk Factors ; Predictive Value of Tests ; Ventricular Function, Left/physiology ; Amyloidosis/diagnosis ; Amyloidosis/physiopathology ; Amyloidosis/diagnostic imaging ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/physiopathology ; Survival Rate/trends |
| مستخلص: | Background: Current echocardiographic risk factors for prognosis in cardiac amyloidosis (CA) do not distinguish between the two main subtypes: transthyretin cardiomyopathy (TTR) and immunoglobulin light chain cardiomyopathy (AL), each of which require distinct diagnostic and therapeutic approaches. Additionally, only traditional parameters have been studied with little data on advanced techniques. Accordingly, we sought to determine whether differences exist in 2D transthoracic echocardiography (2DE) predictors of survival between the CA subtypes using a comprehensive approach. Methods: 220 patients (72±12 years) with confirmed CA (AL=89, TTR=131) who underwent 2DE at the time of CA diagnosis were enrolled. Left ventricular (LV) dimensions, indexed mass (LVMi), global longitudinal strain (LVGLS), apical-sparing ratio (LVASR), diastology, right ventricular (RV) size and function indices including tricuspid annular systolic excursion (TAPSE), RV free-wall (RVFWS) and global (RVGLS) strain, indexed left (LA) and right atrial volumes (LAVi and RAVi), LA strain (reservoir and booster) and RV systolic pressure (RVSP) were measured. A propensity-score weighted stepwise variable selection Cox proportional hazards model derived from NYHA class and renal impairment status at diagnosis was used to determine the associations between 2DE parameters and mortality specific to CA subtype over a median follow-up of 36-months. Results: After adjusting for age, atrial fibrillation and treatment, parameters associated with survival were RVFWS (p=0.003, HR 1.15, 95% CI[1.053,1.245]) and RVSP (p=0.03, HR 1.03, 95% CI[1.004,1.063]) in AL and LVASR (p=0.007, HR 6.68, 95% CI[1.75,25.492]) and RAVi (p=0.049, HR 1.03, 95% CI[1.000,1.052]) in TTR. Conclusions: Echocardiographic prognosticators for survival are specific to cardiac amyloid subtype. These results potentially provide information critical for clinical decision-making and follow-up in these patients. Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Karima Addetia reports financial support was provided by Pfizer Inc. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2024 Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Apical sparing pattern; Light chain amyloidosis; Longitudinal strain; Prognosis; TTR amyloidosis |
| SCR Disease Name: | Amyloidosis, Hereditary, Transthyretin-Related |
| تواريخ الأحداث: | Date Created: 20240630 Date Completed: 20240729 Latest Revision: 20240729 |
| رمز التحديث: | 20240730 |
| DOI: | 10.1016/j.cpcardiol.2024.102729 |
| PMID: | 38945183 |
| قاعدة البيانات: | MEDLINE |
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