Focused review on nutritional status of patients with immunoglobulin light chain amyloidosis

Grigoletti, Shana Souza; Zuchinali, Priccila; Lemieux-Blanchard, Émilie; Béchard, Stéphanie; Lemieux, Bernard; Ribeiro, Paula Aver Bretanha; Tournoux, François

doi:10.1016/j.currproblcancer.2021.100833

Cited by 3 publications

(3 citation statements)

References 51 publications

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“…A large study suggested that according to BMI values, the prevalence of malnutrition ranged from 3% to 42% [ 31 ]. However, if used alone, BMI is a poor indicator of malnutrition and misclassifies malnourished patients within the normal range.…”

Section: Malnutrition and Evaluation Of The Nutritional Statusmentioning

confidence: 99%

“…The independent association between malnutrition, prognosis and quality of life in patients with amyloidosis has been explored in different studies [ 29 , 30 , 31 ]. The assessment of body composition using outpatient methods allows for monitoring the development of the disease and the nutritional status [ 29 ].…”

Section: Malnutrition and Evaluation Of The Nutritional Statusmentioning

confidence: 99%

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Pathophysiology, Functional Assessment and Prognostic Implications of Nutritional Disorders in Systemic Amyloidosis

Dongiglio

Monda

Palmiero

et al. 2023

JCM

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Gastrointestinal involvement is a common clinical feature of patients with systemic amyloidosis. This condition is responsible for invalidating gastrointestinal symptoms, a significant macro and micronutrient deficit, and is a marker of disease severity. Gastrointestinal involvement should be actively sought in patients with systemic amyloidosis, while its diagnosis is challenging in patients with isolated gastrointestinal symptoms. The nutritional status in systemic amyloidosis plays an essential role in the clinical course and is considered a significant prognostic factor. However, the definition of nutritional status is still challenging due to the lack of internationally accepted thresholds for anthropometric and biochemical variables, especially in specific populations such as those with systemic amyloidosis. This review aims to elucidate the fundamental steps for nutritional assessment by using clinical and instrumental tools for better prognostic stratification and patient management regarding quality of life and outcomes.

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Section: Malnutrition and Evaluation Of The Nutritional Statusmentioning

confidence: 99%

Section: Malnutrition and Evaluation Of The Nutritional Statusmentioning

confidence: 99%

Pathophysiology, Functional Assessment and Prognostic Implications of Nutritional Disorders in Systemic Amyloidosis

Dongiglio

Monda

Palmiero

et al. 2023

JCM

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“…Weight loss of 20 lbs (9 kg) or greater is reported in 17-70% of patients. 33 As measured using modified body mass index, malnutrition occurs in up to 64% of variant ATTR cardiac amyloidosis patients and 59% of those with wild-type ATTR cardiac amyloidosis. 34,35 Frailty is estimated to occur in 33-50% of patients with wild-type ATTR cardiac amyloidosis, in domains including (among others) autonomy, balance and muscle weakness.…”

Section: Extra-cardiac Disease Downstream Effects and Patient Selecti...mentioning

confidence: 99%

Implications of Extra-cardiac Disease in Patient Selection for Heart Transplantation: Considerations in Cardiac Amyloidosis

et al. 2023

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Disease-modifying therapies in both light chain and transthyretin amyloidosis have improved patient functional status and survival. Conceivably, as heart failure may progress despite amyloid therapies, more patients may be considered for heart transplantation. In earlier eras, extra-cardiac amyloid deposits significantly reduced post-heart transplant patient survival and functional status compared to the non-amyloid population. In the modern era, transplant centres have reported improved outcomes in amyloidosis as patient selection has grown more stringent. Importantly, systematic candidate evaluation should assess the degree of extra-cardiac involvement, the effectiveness of disease-modifying therapies and downstream effects on patients’ nutrition and frailty. This review outlines such an overall approach while also considering that organ-specific selection criteria may vary between individual transplant centres. A methodical approach to patient evaluation will promote better understanding of the prevalence and severity of extra-cardiac disease in amyloidosis patients referred for heart transplantation and of any disparities in decision outcomes in this population.

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Modified Body Mass Index as a Novel Nutritional and Prognostic Marker in Patients with Cardiac Amyloidosis

et al. 2022

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The nutritional assessment is gaining clinical relevance since cardiac cachexia and malnutrition are emerging as novel markers of functional status and prognosis in many cardiovascular disorders, including cardiac amyloidosis (CA). This study aimed to evaluate the prognostic role of different nutritional indices for cardiovascular mortality in patients with CA and subgroups. Fifty CA patients (26 AL and 24 ATTR wild-type) were retrospectively analyzed. All patients underwent a comprehensive clinical and laboratory evaluation. Conventional body mass index (cBMI), modified BMI (mBMI), new BMI (nBMI) and prognostic nutritional index (PNI) were analyzed. Multivariate regression analysis was performed to identify the association between nutritional and other clinical-laboratory parameters with cardiovascular death. Compared to ATTRwt patients, those with AL showed lower mBMI values. No significant difference was observed for the other nutritional indices. During a median follow-up of 11.2 months, a lower mBMI quartile was associated with worse survival, in both groups. In multivariate analysis, mBMI emerged as an independent predictor for cardiovascular death. This study showed that mBMI is a novel index of malnutrition and an independent risk factor for cardiovascular mortality in patients with CA in both AL and ATTRwt form.

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Focused review on nutritional status of patients with immunoglobulin light chain amyloidosis

Cited by 3 publications

References 51 publications

Pathophysiology, Functional Assessment and Prognostic Implications of Nutritional Disorders in Systemic Amyloidosis

Pathophysiology, Functional Assessment and Prognostic Implications of Nutritional Disorders in Systemic Amyloidosis

Implications of Extra-cardiac Disease in Patient Selection for Heart Transplantation: Considerations in Cardiac Amyloidosis

Modified Body Mass Index as a Novel Nutritional and Prognostic Marker in Patients with Cardiac Amyloidosis

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