Frailty in Older Patients with Transthyretin Cardiac Amyloidosis.

Autor: Cazalbou S; Department of Cardiology, University Hospital of Toulouse, 31400 Toulouse, France.; Cardiac Imaging Center, University Hospital of Toulouse, 31059 Toulouse, France., Naccache L; Geriatrics Department, Internal Medicine and Cardiogeriatry Unit, Toulouse University Hospital, 31059 Toulouse, France., Sourdet S; Geriatrics Department, Internal Medicine and Cardiogeriatry Unit, Toulouse University Hospital, 31059 Toulouse, France., Cariou E; Department of Cardiology, University Hospital of Toulouse, 31400 Toulouse, France.; Cardiac Imaging Center, University Hospital of Toulouse, 31059 Toulouse, France., Fournier P; Department of Cardiology, University Hospital of Toulouse, 31400 Toulouse, France.; Cardiac Imaging Center, University Hospital of Toulouse, 31059 Toulouse, France., Nourhashemi F; Geriatrics Department, Internal Medicine and Cardiogeriatry Unit, Toulouse University Hospital, 31059 Toulouse, France.; French National Institute of Health and Medical Research, Toulouse III Paul Sabatier University, 31062 Toulouse, France.; Medical School of Medicine, Toulouse III Paul Sabatier University, 31062 Toulouse, France., Balardy L; Geriatrics Department, Internal Medicine and Cardiogeriatry Unit, Toulouse University Hospital, 31059 Toulouse, France.; French National Institute of Health and Medical Research, Toulouse III Paul Sabatier University, 31062 Toulouse, France., Toulza O; Geriatrics Department, Internal Medicine and Cardiogeriatry Unit, Toulouse University Hospital, 31059 Toulouse, France., Lairez O; Department of Cardiology, University Hospital of Toulouse, 31400 Toulouse, France.; Cardiac Imaging Center, University Hospital of Toulouse, 31059 Toulouse, France.; Medical School of Medicine, Toulouse III Paul Sabatier University, 31062 Toulouse, France.; Department of Nuclear Medicine, University Hospital of Toulouse, 31059 Toulouse, France., Steinmeyer Z; Geriatrics Department, Internal Medicine and Cardiogeriatry Unit, Toulouse University Hospital, 31059 Toulouse, France., On Behalf Of The Toulouse Amyloidosis Research Network
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2023 Dec 05; Vol. 12 (24). Date of Electronic Publication: 2023 Dec 05.
DOI: 10.3390/jcm12247507
Abstrakt: Background-Transthyretin cardiac amyloidosis (ATTR-CA) prevalence increases with age. The interplay between frailty and heart failure has been increasingly recognized. The objective of this study is to compare clinical, biological, and transthoracic echocardiography (TTE) characteristics of older ATTR-CA patients according to the G8 frailty screening tool. Methods-Patients over 75 years old with a confirmed diagnosis of ATTR-CA were included between January 2020 and April 2021. All patients underwent a routine blood test, TTE, and a functional assessment with a six-minute walking distance test (6MWD) or cardiopulmonary exercise testing (CPET), and the G8 score was calculated. Results-Fifty-two patients were included. Thirty-nine (75%) patients were frail and their mean NYHA stage was more severe (2.2 vs. 1.7; p = 0.004); 62% of them had a Gilmore stage of 2 or 3 ( p = 0.05). Global left ventricular strain (GLS) was lower (-11.7% vs. -14.9%; p = 0.014) and the interventricular septum was thicker (18 ± 2 mm vs. 17 ± 2 mm; p = 0.033) in frail patients. There were no significant differences according to functional tests. Conclusion-The majority of older patients with ATTR-CA are frail according to the G8 score. They are more symptomatic and have an increased cardiac involvement and a poorer prognosis, requiring more personalized cardiac management.
Databáze: MEDLINE
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