Biohumoral markers as predictor of right ventricular dysfunction in AL Amyloidosis

Autor:	Gabriele Ciuti, Niccolò Marchionni, Alessia Fabbri, Franco Bergesio, Samuele Baldasseroni, Elisa Grifoni, Federico Perfetto, Alberto Moggi Pignone, Francesca Tarantini, Gian Franco Gensini, Francesco Cappelli, Paola Attanà, Luigi Padeletti
Rok vydání:	2014
Předmět:	Male medicine.medical_specialty medicine.drug_class Ventricular Dysfunction Right Internal medicine Natriuretic Peptide Brain Troponin I Internal Medicine medicine AL amyloidosis Natriuretic peptide Humans Immunoglobulin Light-chain Amyloidosis Aged biology business.industry Amyloidosis Fractional shortening Middle Aged medicine.disease Troponin Peptide Fragments Right ventricular dysfunction Logistic Models medicine.anatomical_structure Echocardiography Ventricle Cardiology biology.protein Female business Biomarkers
Zdroj:	Amyloid. 21:97-102
ISSN:	1744-2818 1350-6129
DOI:	10.3109/13506129.2014.884971
Popis:	In AL amyloidosis, the importance of right ventricle (RV) involvement has recently been underlined and its role in predicting prognosis has been emphasized. Little is known about the relationship between RV involvement, N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin levels. Aim of our study was to clarify the relationship between NT-proBNP and troponin and RV involvement and analyze their independent value as predictors of RV dysfunction.We examined 76 consecutive patients with biopsy-proven AL amyloidosis. Each patient received complete clinical evaluation, troponin I, NT-proBNP assay and comprehensive echocardiographic evaluation. Considering a tricuspidal annulus plane systolic excursion (TAPSE) value16 mm, 23 patients (30%) presented RV systolic dysfunction, whereas 53 (70%) did not. Patient with reduced TAPSE had thicker left ventricle (LV) walls and RV free walls, reduced LV fractional shortening, impaired LV diastolic function and worse LV and RV myocardial performance index. For RV dysfunction the best predictive value for NT-proBNP was identified as 2977 ng/l with sensitivity and specificity of 87% and 84%, respectively; best cut-off for troponin I was identified as 0.085 ng/l, with sensitivity and specificity of 85% and 90% respectively. At multivariable logistic regression analysis, both NT-proBNP and troponin I emerged as independent predictors of RV dysfunction presence but troponin appears to have a higher predictive power.Our study demonstrated that cut-off values of 2977 ng/ml for NT-proBNP and 0.085 ng/l for troponin were able to identify a subgroup of AL patients with RV dysfunction. Troponin I is more accurate and seems to be the best biohumoral marker of RV dysfunction.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9b3dd3d6afc34fe5ad207ab40758d712 https://doi.org/10.3109/13506129.2014.884971 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.