Association of Left Atrial Hemodynamics by Magnetic Resonance Imaging With Long‐Term Outcomes in Patients With Cardiac Amyloidosis

Benjamin, Mina M.; Arora, P.; Munir, Muhammad S; Darki, Amir; Liebo, Max; Yu, Mingxi; Syed, Mushabbar A.; Kinno, Menhel

doi:10.1002/jmri.28320

Cited by 4 publications

(4 citation statements)

References 36 publications

(34 reference statements)

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“…PALS has been identified as a sensitive prognostic marker in many diseases including hypertension, diabetes, chronic renal disease, atrial fibrillation, cardiotoxicity, heart failure, and valvular heart disease. 12,[39][40][41] PALS has also been identified as a predictor of cardiovascular morbidity and mortality in the general population. 42 These disease states introduce cardiovascular pressure and volume overload or arrhythmic insult that can result in adverse atrial myocardial tissue remodeling.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic value of left atrial strain in aortic stenosis: A systematic review

Lacy,

Thomas,

Syed

et al. 2024

Echocardiography

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PurposeAortic stenosis (AS) is a common valvular heart disease with high morbidity and mortality. Recently, the association between peak atrial longitudinal strain (PALS) and AS clinical outcomes has been identified. This systematic review evaluates the prognostic value of PALS for adverse events in AS.MethodsWe performed a systematic literature review to identify clinical studies that evaluated Speckle–Tracking Echocardiography (STE)‐derived PALS to predict adverse outcomes in patients with AS. We excluded studies that compared echocardiography to computed tomography and studies that focused on diseases other than AS.ResultsWe included 18 studies reporting on 2660 patients. Patients with symptomatic AS had decreased PALS when compared to patients with asymptomatic AS. Patients with AS who had adverse events had decreased PALS when compared to patients with AS with no events. Each unit increase of PALS was independently associated with decreased risk for the primary endpoint. PALS cut‐off values were associated with increased risk for the primary endpoint.ConclusionThis systematic review suggests PALS as an independent predictor for cardiovascular events in patients with AS and highlights the importance of evaluating LA mechanics for AS prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prognostic value of left atrial strain in aortic stenosis: A systematic review

Lacy,

Thomas,

Syed

et al. 2024

Echocardiography

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“…Finally, in a study performed on 51 patients with proven CA, Benjamin et al . [ 61 ] also showed, in a median follow up of 4.9 months, a lower LA strain and higher LA volumes at CMR scans in opposite to 51 age-, gender-, and race-matched SR subjects and without cardiovascular disease (CVD).…”

Section: Cardiac Magnetic Resonance Imagingmentioning

confidence: 99%

Current Perspectives on Atrial Amyloidosis: A Narrative Review

Tana,

Guglielmi

et al. 2024

Rev. Cardiovasc. Med.

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Amyloidosis is a systemic disease caused by low molecular weight protein accumulation in the extracellular space, which can lead to different degrees of damage, depending of the organ or tissue involved. The condition is defined cardiac amyloidosis (CA) when heart is affected, and it is associated with an unfavorable outcome. Different types of CA have been recognized, the most common (98%) are those associated with deposition of light chain (AL-CA), and the form secondary to transthyretin deposit. The latter can be classified into two types, a wild type (transthyretin amyloidosis wild type (ATTRwt)-CA), which mainly affects older adults, and the hereditary or variant type (ATTRh-CA or ATTRv-CA), which instead affects more often young people and is associated with genetic alterations. The atrial involvement can be isolated or linked to CA with a nonspecific clinical presentation represented by new onset atrial fibrillation (AF), diastolic dysfunction and heart failure with preserved ejection fraction, or thromboembolism and stroke. Untreated patients have a median survival rate of 9 years for AL-CA and 7 years for ATTR-CA. By contrast, AL-CA and ATTR-CA treated patients have a median survival rate of 24 and 10 years, respectively. Atrial involvement in CA is a common but poor studied event, and alterations of performance can anticipate the anatomical damage. Recently, numerous advances have been made in the diagnostic field with improvements in the available techniques. An early diagnosis therefore allows a more effective therapeutic strategy with a positive impact on prognosis and mortality rate. A multimodality approach to the diagnosis of atrial involvement from CA is therefore recommended, and standard echocardiography, advanced Doppler-echocardiography (DE) and cardiac magnetic resonance (CMR) can be useful to detect early signs of CA and to estabilish an appropriate treatment.

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“…5 In this issue of JMRI, Arora et al aimed to investigate the association of left atrium (LA) function and strain parameters with long-term clinical outcome in CA patients. 8 The study utilized cardiac MRI feature tracking (MRI-FT) in order to compare LA hemodynamic and strain parameters between control and CA-affected patients. MRI-FT is a relatively quick postprocessing technique that is used to assess myocardial mechanics such as global and regional myocardial function.…”

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confidence: 99%