Naslov
Serial apical deformation change is predictive of outcome in patients with cardiac amyloidosis.

Autori
Hu, Kai ; Liu, Dan ; Niemann, Markus ; Herrmann, Sebastian ; Čikeš, Maja ; Gaudron, Philipp Daniel ; Knop, S. ; Ertl, Georg ; Bijnens, Bart ; Weidemann, Frank.

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
European Heart Journal - Cardiovascular Imaging / - , 2013, Ii199-ii199

Skup
Euroecho 2013

Mjesto i datum
Istanbul, Turska, 11.12.2013. - 14.12.2013

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Amyloidosis; LV hypertrophy; speckle tracking imaging; regional LV function.

Sažetak
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.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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