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Disease progression in cardiac morphology and function in heart failure: ATTR cardiac amyloidosis versus hypertensive left ventricular hypertrophy
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.ORCID iD: 0000-0002-6089-5614
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.ORCID iD: 0000-0002-8192-9166
2022 (English)In: Heart and Vessels, ISSN 0910-8327, E-ISSN 1615-2573, Vol. 37, p. 1562-1569Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Transthyretin cardiac amyloidosis (ATTR-CA) is today more frequently recognized but the rate of progression of cardiac dysfunction is not well established. The aim of this study is to investigate the nature of cardiac structure and function changes, over time, in a retrospective cohort of ATTR-CA patients.

METHODS: Fifty-one patients with ATTR-CA (mean age 78 ± 7 years, 30 females) were compared with 20 patients with heart failure but no amyloidosis (HFnCA) (mean age 76 ± 7 years, 5 females), all with septal thickness >  = 14 mm. All patients underwent DPD scintigraphy and an echocardiogram (Echo 2) which was compared with a previous echocardiographic examination (Echo 1), performed at least 3 years before.

RESULTS: Over the follow-up period, the interventricular septal thickness (IVST) and relative wall thickness (RWT) in ATTR-CA increased from 16 (4) to 18 (5) mm and from 0.51 (0.17) to 0.62 (0.21) respectively, p < 0.001 for both, by a mean increase of 0.4 mm/year and 0.03 mm/year, (p = 0.009 and p = 0.002 compared with HFnCA), respectively. RWT > 0.45 (AUC = 0.77) and RELAPS > 2.0 (AUC 0.86) both predicted positive DPD diagnosis for ATTR-CA.

CONCLUSION: In ATTR-CA patients, the overtime-increase in RWT and IVST was worse than that seen in patients with heart failure but no cardiac amyloidosis. Also, RWT and relative apical sparing predicted diagnosis of ATTR-CA, thus could strengthen the use of follow-up echocardiographic findings as red flag for the diagnosis of ATTR-CA.

Place, publisher, year, edition, pages
Springer, 2022. Vol. 37, p. 1562-1569
Keywords [en]
Cardiac amyloidosis, DPD scintigraphy, Echocardiography, Prognosis
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-193208DOI: 10.1007/s00380-022-02048-5ISI: 000767750300001PubMedID: 35275264Scopus ID: 2-s2.0-85126085900OAI: oai:DiVA.org:umu-193208DiVA, id: diva2:1645892
Funder
Swedish Heart Lung Foundation, 20160787Swedish Heart Lung Foundation, 20200160Swedish Research Council, 2019–01338Available from: 2022-03-21 Created: 2022-03-21 Last updated: 2022-11-28Bibliographically approved

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Henein, Michael Y.Pilebro, BjörnLindqvist, Per

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