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

Autori
Liu, D ; Hu, K ; Cikes, M ; Stoerk, S ; Kramer, B ; Herrmann, S ; Gaudron, PD ; Ertl, G ; Bijnens, B ; Weidemann, F

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

Izvornik
European Heart Journal / - , 2014

Skup
ESC Congress 2014

Mjesto i datum
Barcelona, Španjolska, 30.08.2014. - 03.09.2014

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Serial apical deformation; cardiac amyloidosis

Sažetak
Purpose: Apical sparing pattern with preserved longitudinal systolic strain (LSsys) at apical segments and significantly reduced LSsys at mid and basal segments is a typical finding in patients with cardiac amyloidosis (CA). Reduced mid-septal LSsys is associated with poor outcome in CA patients. The purpose of this prospective study was to explore the predicting value of monitoring regional LSsys on outcome in CA patients. Methods: Standard echocardiography was performed in 38 biopsy proven CA patients (mean age 65°æ10 years ; 55% male) at baseline and during echocardiographic follow-up (median 278 days). Global and segmental LSsys were offline assessed by two-dimensional speckle tracking imaging in septal and lateral walls of left ventricle (LV) from apical 4-chamber view. All patients were clinically followed-up by clinical visit or telephone call (median 486 days). The primary endpoint was defined as all-cause death. Results: Twenty out of 38 (53%) patients died during clinical follow-up. During follow up, NYHA class was significantly increased in non-survivors while remained unchanged in survivors, LV wall thickness and right ventricular dimension were significantly increased in both non-survivors and survivors (all P<0.05), LV global and regional LSsys remained unchanged in survivors while septal and lateral LSsys at apical segments were significantly reduced in non-survivors (septal: -18°æ6% vs. 15°æ7%, P=0.022 ; lateral: -16°æ7 vs. 12°æ6, P=0.006). Univariate Cox analysis showed that baseline NYHA class (HR 2.75, P=0.034), LV mass index (HR 2.97, P=0.042), mid-septal LSsys, (HR 2.82, P=0.028), LSsys reduction of apical-septal (HR 3.34, P=0.016) and apical-lateral (HR 5.61, P=0.001) segments during follow-up were predictors of mortality. Apical-septal and apical lateral LSsys remained independent mortality predictors after adjustment for age, gender, baseline NYHA class, LV mass index, and LV ejection fraction. CA patients with apical-septal LSsys reduction >2.5% or apical-lateral LSsys reduction >3.0% during follow-up was associated with a 4-5 fold higher risk of death compared to those with apical-septal LSsys reduction ≤2.5% or apical-lateral LSsys reduction ≤3.0%. Conclusion: Longitudinal systolic strain reduction at apical segments over the follow-up period is an independent predictor of survival in CA patients.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA