Low QRS Voltages in Cardiac Amyloidosis: Clinical Correlates and Prognostic Value.
AL, light chain amyloidosis
ATTR, transthyretin amyloidosis
ATTR-v, variant transthyretin
ATTR-wt, wild-type transthyretin
AUC, area under the curve
BNP, B-type natriuretic peptide
CA, cardiac amyloidosis
CMR, cardiac magnetic resonance
CV, cardiovascular
ECG, electrocardiogram
LQRSV, low QRS voltages
LV, left ventricle
LVEDD, left ventricular end-diastolic diameter
NAC, National Amyloidosis Centre
NT-proBNP, N-terminal pro–B-type natriuretic peptide
NYHA, New York Heart Association
ROC, receiver-operating characteristic
RV, right ventricular
TAPSE, tricuspid annulus peak systolic excursion
cardiac amyloidosis
echocardiography
electrocardiography
low QRS voltages
prognostic significance
risk stratification
Journal
JACC. CardioOncology
ISSN: 2666-0873
Titre abrégé: JACC CardioOncol
Pays: United States
ID NLM: 101761697
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
09
07
2022
revised:
27
08
2022
accepted:
28
08
2022
entrez:
29
11
2022
pubmed:
30
11
2022
medline:
30
11
2022
Statut:
epublish
Résumé
Low QRS voltages (LQRSVs) are a common electrocardiographic feature in patients with light chain amyloidosis (AL) and transthyretin amyloidosis (ATTR) cardiac amyloidosis (CA). The aim of this study was to identify clinical and echocardiographic correlates of LQRSV and to investigate their prognostic significance in patients with CA. This was a multicenter, retrospective study performed in 6 CA referral centers including consecutive patients with AL and ATTR CA. LQRSVs were defined as a QRS amplitude ≤5 mm (0.5 mV) in all peripheral leads. The study outcome was cardiovascular (CV) mortality. Overall, 411 (AL CA: n = 120, ATTR CA: n = 291) patients were included. LQRSVs were present in 66 (55%) patients with AL CA and 103 (35%) with ATTR CA ( LQRSVs are common but not ubiquitous in CA; they are more frequent in AL CA than in ATTR CA. LQRSVs reflect an advanced disease stage and independently predict CV death. In ATTR CA, LQRSVs can provide incremental prognostic accuracy over the NAC staging system in patients with intermediate risk.
Sections du résumé
Background
UNASSIGNED
Low QRS voltages (LQRSVs) are a common electrocardiographic feature in patients with light chain amyloidosis (AL) and transthyretin amyloidosis (ATTR) cardiac amyloidosis (CA).
Objectives
UNASSIGNED
The aim of this study was to identify clinical and echocardiographic correlates of LQRSV and to investigate their prognostic significance in patients with CA.
Methods
UNASSIGNED
This was a multicenter, retrospective study performed in 6 CA referral centers including consecutive patients with AL and ATTR CA. LQRSVs were defined as a QRS amplitude ≤5 mm (0.5 mV) in all peripheral leads. The study outcome was cardiovascular (CV) mortality.
Results
UNASSIGNED
Overall, 411 (AL CA: n = 120, ATTR CA: n = 291) patients were included. LQRSVs were present in 66 (55%) patients with AL CA and 103 (35%) with ATTR CA (
Conclusions
UNASSIGNED
LQRSVs are common but not ubiquitous in CA; they are more frequent in AL CA than in ATTR CA. LQRSVs reflect an advanced disease stage and independently predict CV death. In ATTR CA, LQRSVs can provide incremental prognostic accuracy over the NAC staging system in patients with intermediate risk.
Identifiants
pubmed: 36444225
doi: 10.1016/j.jaccao.2022.08.007
pii: S2666-0873(22)00385-4
pmc: PMC9700257
doi:
Types de publication
Journal Article
Langues
eng
Pagination
458-470Informations de copyright
© 2022 The Authors.
Déclaration de conflit d'intérêts
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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