Prognostic and Added Value of Two-Dimensional Global Longitudinal Strain for Prediction of Survival in Patients with Light Chain Amyloidosis Undergoing Autologous Hematopoietic Cell Transplantation
| Autor: | Carol L. Chen, Richard M. Steingart, Anthony F. Yu, Jonathan Jordan, Hani Hassoun, Shawn C. Pun, Elyn Riedel, Jennifer E. Liu, Heather Landau |
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| Rok vydání: | 2018 |
| Předmět: |
Oncology
medicine.medical_specialty Population 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine AL amyloidosis Radiology Nuclear Medicine and imaging education education.field_of_study Ejection fraction biology business.industry Amyloidosis medicine.disease Brain natriuretic peptide Troponin Surgery Transplantation 030220 oncology & carcinogenesis biology.protein Biomarker (medicine) Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the American Society of Echocardiography. 31:64-70 |
| ISSN: | 0894-7317 |
| DOI: | 10.1016/j.echo.2017.08.017 |
| Popis: | Background Autologous hematopoietic cell transplantation (HCT) is a first-line therapy for prolonging survival in patients with light-chain (AL) amyloidosis. Cardiac involvement is the most important determinant of survival. However, patients with advanced cardiac involvement have often been excluded from HCT because of high risk for transplantation-related mortality and poor overall survival. Whether baseline left ventricular global longitudinal strain (GLS) can provide additional risk stratification and predict survival after HCT in this high-risk population remains unclear. The aim of this study was to evaluate the prognostic implication of baseline GLS and the added value of GLS beyond circulating cardiac biomarkers for risk stratification in patients with AL amyloidosis undergoing HCT. Methods Eighty-two patients with newly diagnosed AL amyloidosis who underwent upfront HCT between January 2007 and April 2014 were included in the study. Clinical, echocardiographic, and serum cardiac biomarker data were collected at baseline and 12 months following HCT. GLS measurements were performed using a vendor-independent offline system. The median follow-up time for survivors was 58 months. Results Sixty-four percent of patients were in biomarker-based Mayo stage II or III. GLS, brain natriuretic peptide, troponin, and mitral E/A ratio were identified as the strongest predictors of survival ( P Conclusions GLS is a strong predictor of survival in patients with AL amyloidosis undergoing HCT, potentially providing incremental value over serum cardiac biomarkers for risk stratification. GLS should be considered as a standard parameter along with serum cardiac biomarkers when evaluating eligibility for HCT or other investigational therapies. |
| Databáze: | OpenAIRE |
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