Serial apical deformation change is predictive of outcome in patients with cardiac amyloidosis. (CROSBI ID 605796)
Prilog sa skupa u časopisu | sažetak izlaganja sa skupa | međunarodna recenzija
Podaci o odgovornosti
Hu, Kai ; Liu, Dan ; Niemann, Markus ; Herrmann, Sebastian ; Čikeš, Maja ; Gaudron, Philipp Daniel ; Knop, S. ; Ertl, Georg ; Bijnens, Bart ; Weidemann, Frank.
engleski
Serial apical deformation change is predictive of outcome in patients with cardiac amyloidosis.
Purpose: The aim of this study was to explore the value of monitoring regional left ventricular (LV) function on outcome in patients with proven light- chain (AL) amyloidosis and LV hypertrophy (CA). Cardiac involvement is associated with poor outcome in AL amyloidosis patients. Detecting serial changes of regional LV function using advanced non-invasive echocardiography might be useful for predicting outcome in CA patients. Methods: LV septal and lateral longitudinal peak systolic strain rate (LSRsys) and strain (LSsys) were assessed by 2D-speckle tracking imaging in 35 biopsy proven CA patients at baseline and during echocardiographic follow-up (median 189 days, interquartile range 98 to 529 days). All patients were clinically followed-up for a median period of 567 (interquartile range 249 to 1063) days. The end point was all-cause mortality. The clinical and echocardiographic data at baseline and during follow-up were compared between survived (n=19) and died (n=16) CA patients. Results: Baseline mean NYHA class and E/E' were significantly higher while mitral annular plane systolic excursion (MAPSE) was significantly lower in died patients compared to survived patients (all p<0.05). At baseline, LSRsys and LSsys were similar at apical segments but were significantly lower at basal segments in died patients as compared to survived patients. Compared to baseline, LV stroke volume (baseline 47±20 ml vs. follow-up 41±18 ml, P=0.389), and septal apical LSsys (-17±5% vs. -13±7%, P=0.099) and lateral apical LSsys (-16±6% vs. -12±7%, P=0.102) tended to decrease in died patients while tended to increase in survived patients at follow-up examination (Delta change between died and survived: P=0.025 and 0.004). Consequently, septal apical LSsys reduction >2.7% between baseline and follow-up was associated with a 3.8-fold mortality risk compared to septal apical LSsys reduction ≤2.7% in CA patients. Multivariate regression analysis showed that reduction of the septal apical LSsys during follow-up was an independent predictor of poor survival in patients with CA. Conclusion: Reduced deformation in septal apical segments during follow-up is associated with increased mortality in CA patients.
Amyloidosis; LV hypertrophy; speckle tracking imaging; regional LV function.
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Podaci o prilogu
ii199-ii199.
2013.
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objavljeno
Podaci o matičnoj publikaciji
European Heart Journal - Cardiovascular Imaging
2047-2404
Podaci o skupu
EUROECHO 2013
poster
11.12.2013-14.12.2013
Istanbul, Turska