Incidence and Predictors of Ventricular Arrhythmias in Transthyretin Amyloid Cardiomyopathy.
amyloidosis
cardiomyopathy
transthyretin
ventricular arrhythmia
ventricular tachycardia
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
11 Jul 2023
11 Jul 2023
Historique:
received:
18
06
2023
revised:
29
06
2023
accepted:
03
07
2023
medline:
29
7
2023
pubmed:
29
7
2023
entrez:
29
7
2023
Statut:
epublish
Résumé
Wild-type transthyretin amyloid cardiomyopathy (wtATTR-CM) is characterized by heart failure, conduction abnormalities and arrhythmias. The incidence of ventricular arrhythmias, particularly ventricular tachycardias (VTs), in wtATTR-CM is unclear. With the development of targeted therapies and improved overall prognosis, there is an unmet need to identify patients at high risk for VTs who might benefit from ICD therapy. Between 2017 and 2022, 72 patients diagnosed with wtATTR-CM were prospectively evaluated for the presence of ventricular arrhythmias using a Holter ECG. VTs were defined as >3 consecutive beats with a heart rate > 100 beats per minute originating from a ventricle. The incidence of VTs was 44% (n = 32/72) in unselected wtATTR-CM patients. Patients with VT showed significantly more severe left ventricular (LV) hypertrophy (septum diameter 21 ± 2.6 vs. 19 ± 3.0 mm, The incidence of ventricular arrhythmia in wtATTR-CM is high and is associated with an advanced stage of left ventricular disease. Further studies are needed evaluating the role of VTs in predicting sudden cardiac death and the benefit of ICD therapy in wtATTR-CM.
Sections du résumé
BACKGROUND
BACKGROUND
Wild-type transthyretin amyloid cardiomyopathy (wtATTR-CM) is characterized by heart failure, conduction abnormalities and arrhythmias. The incidence of ventricular arrhythmias, particularly ventricular tachycardias (VTs), in wtATTR-CM is unclear. With the development of targeted therapies and improved overall prognosis, there is an unmet need to identify patients at high risk for VTs who might benefit from ICD therapy.
METHODS
METHODS
Between 2017 and 2022, 72 patients diagnosed with wtATTR-CM were prospectively evaluated for the presence of ventricular arrhythmias using a Holter ECG. VTs were defined as >3 consecutive beats with a heart rate > 100 beats per minute originating from a ventricle.
RESULTS
RESULTS
The incidence of VTs was 44% (n = 32/72) in unselected wtATTR-CM patients. Patients with VT showed significantly more severe left ventricular (LV) hypertrophy (septum diameter 21 ± 2.6 vs. 19 ± 3.0 mm,
CONCLUSIONS
CONCLUSIONS
The incidence of ventricular arrhythmia in wtATTR-CM is high and is associated with an advanced stage of left ventricular disease. Further studies are needed evaluating the role of VTs in predicting sudden cardiac death and the benefit of ICD therapy in wtATTR-CM.
Identifiants
pubmed: 37510739
pii: jcm12144624
doi: 10.3390/jcm12144624
pmc: PMC10380522
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : Pfizer (Germany)
ID : Global Medical Grant 64911533
Références
Circulation. 2016 Jun 14;133(24):2404-12
pubmed: 27143678
Amyloid. 2022 Sep;29(3):211-212
pubmed: 35451897
Int J Cardiol. 2022 Feb 15;349:99-102
pubmed: 34843821
J Am Coll Cardiol. 2016 Sep 6;68(10):1014-20
pubmed: 27585505
Acta Cardiol Sin. 2022 Jul;38(4):464-474
pubmed: 35873126
Eur Heart J Cardiovasc Imaging. 2015 Mar;16(3):233-70
pubmed: 25712077
J Am Heart Assoc. 2020 Sep 15;9(18):e016038
pubmed: 32867553
Transplantation. 2004 Jul 15;78(1):112-6
pubmed: 15257048
Eur J Heart Fail. 2021 Jun;23(6):895-905
pubmed: 33915002
Circulation. 1977 Apr;55(4):613-8
pubmed: 138494
JACC CardioOncol. 2021 Oct 19;3(4):506-515
pubmed: 34729522
N Engl J Med. 2018 Sep 13;379(11):1007-1016
pubmed: 30145929
Europace. 2020 Aug 1;22(8):1216-1223
pubmed: 32514579
Circ Heart Fail. 2020 Mar;13(3):e006619
pubmed: 32164434
ESC Heart Fail. 2020 Dec;7(6):3919-3928
pubmed: 33002335
Eur Heart J. 2015 Oct 7;36(38):2585-94
pubmed: 26224076
Stat Methods Med Res. 2019 Aug;28(8):2455-2474
pubmed: 29966490
Pacing Clin Electrophysiol. 2001 Aug;24(8 Pt 1):1228-33
pubmed: 11523608
Circulation. 2022 Nov 29;146(22):1657-1670
pubmed: 36325894
BMC Cardiovasc Disord. 2021 Sep 8;21(1):425
pubmed: 34496747
Am J Cardiol. 2021 Mar 15;143:125-130
pubmed: 33352208
Eur J Heart Fail. 2022 Sep;24(9):1700-1712
pubmed: 35779241
Heart Rhythm. 2014 Jan;11(1):158-62
pubmed: 24121001
Eur Heart J Cardiovasc Imaging. 2016 Dec;17(12):1321-1360
pubmed: 27422899
Eur Heart J. 2021 Apr 21;42(16):1554-1568
pubmed: 33825853
Circulation. 2020 Jul 7;142(1):e7-e22
pubmed: 32476490
Am J Cardiol. 2009 Oct 1;104(7):990-4
pubmed: 19766769
Pacing Clin Electrophysiol. 2022 Apr;45(4):443-451
pubmed: 35257420
Pacing Clin Electrophysiol. 2020 Nov;43(11):1401-1403
pubmed: 32725816
Eur Heart J. 2018 Aug 7;39(30):2799-2806
pubmed: 29048471
J Cardiovasc Electrophysiol. 2013 Jul;24(7):793-8
pubmed: 23489983
Eur Heart J. 2022 Oct 21;43(40):3997-4126
pubmed: 36017572