Atrial electrofunctional predictors of incident atrial fibrillation in cardiac amyloidosis.

Autor:	Sinigiani G; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy., De Michieli L; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy., Porcari A; Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy., Zocchi C; Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy., Sorella A; Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy., Mazzoni C; Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy., Bisaccia G; Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy., De Luca A; Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy., Di Bella G; Rare Cardiac Disease Center, Cardiology Unit, University of Messina, Messina, Italy., Gregori D; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy., Perfetto F; Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy., Merlo M; Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy., Sinagra G; Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy., Iliceto S; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy., Perazzolo Marra M; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy., Corrado D; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy., Ricci F; Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy., Cappelli F; Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy., Cipriani A; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy. Electronic address: alberto.cipriani@unipd.it.
Jazyk:	angličtina
Zdroj:	Heart rhythm [Heart Rhythm] 2024 Jun; Vol. 21 (6), pp. 725-732. Date of Electronic Publication: 2024 Feb 02.
DOI:	10.1016/j.hrthm.2024.01.056
Abstrakt:	Background: Atrial fibrillation (AF) is common in patients with cardiac amyloidosis (CA) and is a significant risk factor for heart failure hospitalization and thromboembolic events. Objective: This study was designed to investigate the atrial electrofunctional predictors of incident AF in CA. Methods: A multicenter, observational study was conducted in 4 CA referral centers including sinus rhythm patients with light-chain (AL) and transthyretin (ATTR) CA undergoing electrocardiography and cardiac magnetic resonance imaging. The primary end point was new-onset AF occurrence. Results: Overall, 96 patients (AL-CA, n = 40; ATTR-CA, n = 56) were enrolled. During an 18-month median follow-up (Q1-Q3, 7-29 months), 30 patients (29%) had incident AF. Compared with those without AF, patients with AF were older (79 vs 73 years; P = .001). They more frequently had ATTR (87% vs 45%; P < .001); electrocardiographic interatrial block (IAB), either partial (47% vs 21%; P = .011) or advanced (17% vs 3%; P = .017); and lower left atrial ejection fraction (LAEF; 29% vs 41%; P = .004). Age (hazard ratio [HR], 1.059; 95% CI, 1.002-1.118; P = .042), any type of IAB (HR, 2.211; 95% CI, 1.03-4.75; P = .041), and LAEF (HR, 0.967; 95% CI, 0.936-0.998; P = .044) emerged as independent predictors of incident AF. Patients exhibiting any type of IAB, LAEF <40%, and age >78 years showed a cumulative incidence for AF of 40% at 12 months. This risk was significantly higher than that carried by 1 (8.5%) or none (7.6%) of these 3 risk factors. Conclusion: In patients with CA, older age, IAB on 12-lead electrocardiography, and reduced LAEF on cardiac magnetic resonance imaging are significant and independent predictors of incident AF. A closer screening for AF is advisable in CA patients carrying these features. Competing Interests: Disclosures A.C. received honoraria from Alnylam, AstraZeneca, and Pfizer. (Copyright © 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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