Progression of echocardiographic parameters and prognosis in transthyretin cardiac amyloidosis

Chacko, Liza; Karia, Nina; Venneri, Lucia; Bandera, Francesco; Passo, Beatrice Dal; Buonamici, Lodovico; Lazari, Jonathan; Porcari, Aldostefano; Patel, Rishi; Razvi, Yousuf; Brown, James; Knight, Daniel; Martinez‐Naharro, Ana; Whelan, Carol; Quarta, Candida Cristina; Manisty, Charlotte; Moon, James; Rowczenio, Dorota; Gilbertson, Janet A.; Lachmann, Helen; Wechelakar, Ashutosh; Petrie, Aviva; Moody, William E.; Steeds, Richard P; Potena, Luciano; Riefolo, Mattia; Leone, Ornella; Rapezzi, Claudio; Hawkins, Philip N.; Gillmore, Julian D.; Fontana, Marianna

doi:10.1002/ejhf.2606

Cited by 38 publications

(34 citation statements)

References 28 publications

(63 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Right ventricle (RV) systolic dysfunction was defined as a tricuspid annular plane systolic excursion (TAPSE) < 17 mm and/or fractional area contraction (FAC) < 35% ( 19 ). The presence and severity of valve disease was defined according to current recommendations ( 20 ).…”

Section: Methodsmentioning

confidence: 99%

Evolving trends in epidemiology and natural history of cardiac amyloidosis: 30-year experience from a tertiary referral center for cardiomyopathies

Porcari

Allegro

Saro

et al. 2022

Front. Cardiovasc. Med.

Self Cite

View full text Add to dashboard Cite

ObjectiveNatural history of cardiac amyloidosis (CA) is poorly understood. We aimed to examine the changing mortality of different types of CA over a 30-year period.Patients and methodsConsecutive patients included in the “Trieste CA Registry” from January 1, 1990 through December 31, 2021 were divided into a historical cohort (diagnosed before 2016) and a contemporary cohort (diagnosed after 2016). Light chain (AL), transthyretin (ATTR) and other forms of CA were defined according to international recommendations. The primary and secondary outcome measures were all-cause mortality and cardiac death, respectively.ResultsWe enrolled 182 patients: 47.3% AL-CA, 44.5% ATTR-CA, 8.2% other etiologies. The number of patients diagnosed with AL and ATTR-CA progressively increased over time, mostly ATTR-CA patients (from 21% before 2016 to 67% after 2016) diagnosed non-invasively. The more consistent increase in event-rate was observed in the long-term (after 50 months) in ATTR-CA compared to the early increase in mortality in AL-CA. In the contemporary cohort, during a median follow up of 16 [4–30] months, ATTR-CA was associated with improved overall and cardiac survival compared to AL-CA. At multivariable analysis, ATTR-CA (HR 0.42, p = 0.03), eGFR (HR 0.98, p = 0.033) and ACE-inhibitor therapy (HR 0.24, p < 0.001) predicted overall survival in the contemporary cohort.ConclusionIncidence and prevalence rates of ATTR-CA and, to a less extent, of AL-CA have been increasing over time, with significant improvements in 2-year survival of ATTR-CA patients from the contemporary cohort. Reaching an early diagnosis and starting disease-modifying treatments will improve long-term survival in CA.

show abstract

Section: Methodsmentioning

confidence: 99%

Evolving trends in epidemiology and natural history of cardiac amyloidosis: 30-year experience from a tertiary referral center for cardiomyopathies

Porcari

Allegro

Saro

et al. 2022

Front. Cardiovasc. Med.

Self Cite

View full text Add to dashboard Cite

show abstract

“…In the last decade the evolution of non-invasive diagnostic methods, specifically cardiac scintigraphy with bone tracers, has gradually changed the diagnostic approach to and clinical management of cardiac ATTR. So, although from the 1990s until the early 2000s EMB was frequently used in referral centers, today it is less common ( 41 , 101 ).…”

Section: Histologic Evaluation: When and Wherementioning

confidence: 99%

Amyloidosis: What does pathology offer? The evolving field of tissue biopsy

Riefolo

Conti

Longhi

et al. 2022

Front. Cardiovasc. Med.

Self Cite

View full text Add to dashboard Cite

Since the mid-nineteenth century pathology has followed the convoluted story of amyloidosis, recognized its morphology in tissues and made identification possible using specific staining. Since then, pathology studies have made a significant contribution and advanced knowledge of the disease, so providing valuable information on the pathophysiology of amyloid aggregation and opening the way to clinical studies and non-invasive diagnostic techniques. As amyloidosis is a heterogeneous disease with various organ and tissue deposition patterns, histology evaluation, far from offering a simple yes/no indication of amyloid presence, can provide a wide spectrum of qualitative and quantitative information related to and changing with the etiology of the disease, the comorbidities and the clinical characteristics of patients. With the exception of cardiac transthyretin related amyloidosis cases, which today can be diagnosed using non-biopsy algorithms when stringent clinical criteria are met, tissue biopsy is still an essential tool for a definitive diagnosis in doubtful cases and also to define etiology by typing amyloid fibrils. This review describes the histologic approach to amyloidosis today and the current role of tissue screening biopsy or targeted organ biopsy protocols in the light of present diagnostic algorithms and various clinical situations, with particular focus on endomyocardial and renal biopsies. Special attention is given to techniques for typing amyloid fibril proteins, necessary for the new therapies available today for cardiac transthyretin related amyloidosis and to avoid patients receiving inappropriate chemotherapy in presence of plasma cell dyscrasia unrelated to amyloidosis. As the disease is still burdened with high mortality, the role of tissue biopsy in early diagnosis to assure prompt treatment is also mentioned.

show abstract

“…In the current issue of the Journal, Chacko and co‐authors 1 describe the natural history of ATTR‐CM (patients received no ATTR‐specific treatment) in an impressively large cohort, including both individuals with hereditary (hATTR‐CM) and non‐hereditary (wtATTR‐CM) disease. In total, 877 patients were included in a single specialized UK centre between 2000 and 2020, and serial echocardiographic follow‐up was performed at 1 and 2 years to investigate structural and functional changes over time.…”

Section: Figurementioning

confidence: 99%

Echocardiographic tracking of transthyretin cardiomyopathy: which parameters matter the most?

Nitsche

2022

European J of Heart Fail

View full text Add to dashboard Cite

Progression of echocardiographic parameters and prognosis in transthyretin cardiac amyloidosis

Cited by 38 publications

References 28 publications

Evolving trends in epidemiology and natural history of cardiac amyloidosis: 30-year experience from a tertiary referral center for cardiomyopathies

Evolving trends in epidemiology and natural history of cardiac amyloidosis: 30-year experience from a tertiary referral center for cardiomyopathies

Amyloidosis: What does pathology offer? The evolving field of tissue biopsy

Echocardiographic tracking of transthyretin cardiomyopathy: which parameters matter the most?

Contact Info

Product

Resources

About