Left ventricular myocardial work improves in response to treatment and is associated with survival among patients with light chain cardiac amyloidosis.

Autor:	Briasoulis, Alexandros, Bampatsias, Dimitrios, Petropoulos, Ioannis, Rempakos, Athanasios, Patras, Raphael, Theodorakakou, Foteini, Makris, Nikolaos, Dimopoulos, Meletios Athanasios, Stamatelopoulos, Kimon, Kastritis, Efstathios
Předmět:	MYOCARDIUM physiology LEFT heart ventricle surgery LEFT heart ventricle SURVIVAL PSYCHOLOGY of cardiac patients CARDIAC amyloidosis CARDIOMYOPATHIES DATA analysis RECEIVER operating characteristic curves TREATMENT effectiveness PEPTIDE hormones DESCRIPTIVE statistics MANN Whitney U Test LOG-rank test STATISTICS GLOBAL longitudinal strain
Zdroj:	European Heart Journal - Cardiovascular Imaging; May2024, Vol. 25 Issue 5, p698-707, 10p
Abstrakt:	Aims Complete haematologic response to treatment for light chain cardiac amyloidosis (AL-CA) may lead to improvement of myocardial function and better outcomes. We sought to evaluate the effect of response to treatment for AL-CA on echocardiographic indices of myocardial deformation and work and their prognostic significance. Methods and results Sixty-one patients treated for AL were enrolled and underwent echocardiographic assessment at baseline and at 1 year. Patients were stratified according to haematologic response as complete or not complete responders. A significant reduction in median N-terminal pro-brain natriuretic peptide (NT-proBNP) (2771–1486 pg/mL; P < 0.001) and posterior wall thickness (13–12 mm; P = 0.002) and an increase in global work index (GWI) (1115–1356 mmHg%; P = 0.018) was observed at 1 year. Patients with complete response (CR) had a more pronounced decrease in intraventricular septum thickness (14.2–12.0 mm; P = 0.006), improved global longitudinal strain (GLS) (−11.6 to −13.1%; P for interaction = 0.045), increased global constructive work (1245–1436 mmHg%; P = 0.008), and GWI (926–1250 mmHg%, P = 0.002) compared with non-CR. Furthermore, deltaGLS (ρspearman = 0.35; P < 0.001) and deltaGWI (ρspearman = −0.32; P = 0.02) correlated with delta NT-proBNP. Importantly, patients with GLS and GWI response had a better prognosis (log-rank P = 0.048 and log-rank P = 0.007, respectively). After adjustment for Mayo stage, gender, and response status, deltaGLS [hazard ratio (HR) = 1.404, P = 0.046 per 1% increase] and deltaGWI (HR = 0.996, P = 0.042 per 1mmHg% increase) were independent predictors of survival. Conclusion Complete haematologic response to treatment is associated with improved left ventricular myocardial work indices, and their change is associated with improved survival in AL-CA. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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