A novel echocardiographic risk score for light-chain amyloidosis

Geenty, P.; Sivapathan, S.; Stefani, L.; Boyd, Anita; Richards, David; Kwok, Fiona; Thomas, Liza

doi:10.1093/ehjopen/oead040

Cited by 4 publications

(2 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Geenty et al . 72 introduced an echocardiographic scoring system that combines both LA volume and LVGLS, demonstrating a comparable ability to predict all-cause mortality as the Mayo stage.…”

Section: Diagnosis Of Amyloidosis In the Setting Of Aortic Stenosismentioning

confidence: 99%

Cardiac amyloidosis and aortic stenosis: a state-of-the-art review

Jaiswal,

Agrawal,

Khulbe

et al. 2023

European Heart Journal Open

View full text Add to dashboard Cite

Cardiac amyloidosis is caused by the extracellular deposition of amyloid fibrils in the heart, involving not only the myocardium but any cardiovascular structure. Indeed, this progressive infiltrative disease also involves the cardiac valves and, specifically, shows a high prevalence with aortic stenosis. Misfolded proteins infiltration in the aortic valve leads to tissue damage resulting in the onset or worsening of valve stenosis. Transthyretin-cardiac amyloidosis and aortic stenosis coexist in patients > 65 years in about 4 to 16% of cases, especially in those undergoing transcatheter aortic valve replacement. Diagnostic work-up for cardiac amyloidosis in patients with aortic stenosis is based on a multiparametric approach considering clinical assessment, electrocardiogram, haematologic tests, basic and advanced echocardiography, cardiac magnetic resonance, technetium labeled cardiac scintigraphy like 99mTc-pyrophosphate, 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid, and 99mTc-hydroxymethylenediphosphonate. However, a biopsy is the traditional gold standard for diagnosis. The prognosis of patients with coexisting cardiac amyloidosis and aortic stenosis is still under evaluation. The combination of these two pathologies worsens the prognosis. Regarding treatment, mortality is reduced in patients with cardiac amyloidosis and severe aortic stenosis after undergoing transcatheter aortic valve replacement. Further studies are needed to confirm these findings and to understand whether the diagnosis of cardiac amyloidosis could affect therapeutic strategies. The aim of this review is to critically expose the current state-of-art regarding the association of cardiac amyloidosis with aortic stenosis, from pathophysiology to treatment.

show abstract

Section: Diagnosis Of Amyloidosis In the Setting Of Aortic Stenosismentioning

confidence: 99%

Cardiac amyloidosis and aortic stenosis: a state-of-the-art review

Jaiswal,

Agrawal,

Khulbe

et al. 2023

European Heart Journal Open

View full text Add to dashboard Cite

show abstract

“… 18 Furthermore, in Arrhythmia & Electrophysiology , Ullah et al used nationwide health data to conclude that atrial fibrillation ablation was associated with significantly higher net adverse clinical events in patients with CA, 19 albeit atrial fibrillation catheter ablation remains effective to maintain sinus rhythm in patients with CA. 20 Finally, novel findings on Vascular & Cardiac Imaging of CA include a suggested novel echocardiographic risk score 21 and CA prognostic prediction by cardiac magnetic resonance imaging (cMRI). 22 …”

mentioning

confidence: 99%

Editors’ highlight picks from 2023 in EHJ Open

Bäck,

Banach,

Braunschweig

et al. 2023

European Heart Journal Open

View full text Add to dashboard Cite

Sex-specific cardiac magnetic resonance pulmonary capillary wedge pressure

Garg,

Grafton-Clarke,

Matthews

et al. 2024

European Heart Journal Open

View full text Add to dashboard Cite

Aims Heart failure (HF) with preserved ejection fraction disproportionately affects women. There are no validated sex-specific tools for HF diagnosis despite widely reported differences in cardiac structure. This study investigates whether sex, as assigned at birth, influences cardiac magnetic resonance (CMR) assessment of left ventricular filling pressure (LVFP), a hallmark of HF agnostic to ejection fraction. Methods and results A derivation cohort of patients with suspected pulmonary hypertension and HF from the Sheffield centre underwent invasive right heart catheterization and CMR within 24 h of each other. A sex-specific CMR model to estimate LVFP, measured as pulmonary capillary wedge pressure (PCWP), was developed using multivariable regression. A validation cohort of patients with confirmed HF from the Leeds centre was used to evaluate for the primary endpoints of HF hospitalization and major adverse cardiovascular events (MACEs). Comparison between generic and sex-specific CMR-derived PCWP was undertaken. A total of 835 (60% female) and 454 (36% female) patients were recruited into the derivation and validation cohorts respectively. A sex-specific model incorporating left atrial volume and left ventricular mass was created. The generic CMR PCWP showed significant differences between males and females (14.7 ± 4 vs. 13 ± 3.0 mmHg, P > 0.001), not present with the sex-specific CMR PCWP (14.1 ± 3 vs. 13.8 mmHg, P = 0.3). The sex-specific, but not the generic, CMR PCWP was associated with HF hospitalization (hazard ratio 3.9, P = 0.0002) and MACE (hazard ratio 2.5, P = 0.001) over a mean follow-up period of 2.4 ± 1.2 years. Conclusion Accounting for sex improves precision and prognostic performance of CMR biomarkers for HF.

show abstract

A novel echocardiographic risk score for light-chain amyloidosis

Cited by 4 publications

References 26 publications

Cardiac amyloidosis and aortic stenosis: a state-of-the-art review

Cardiac amyloidosis and aortic stenosis: a state-of-the-art review

Editors’ highlight picks from 2023 in EHJ Open

Sex-specific cardiac magnetic resonance pulmonary capillary wedge pressure

Contact Info

Product

Resources

About