OBJECTIVE: Light chain amyloidosis (AL) is associated with high mortality. The aim was to identify echocardiographic parameters that predict AL long-term mortality. METHODS: Forty-two subjects with biopsy-proven AL (43% were female; aged 61 +/- 12 years) underwent echocardiography and were followed 29 +/- 16 months (median 29.4 months). Standard echocardiographic and clinical parameters and heart failure (HF) class were tested using univariate/multivariable Cox proportional hazard regression analyses to identify markers of mortality. RESULTS: Twenty-three subjects died, with a 1-year mortality of 44%. Univariate predictors of mortality were HF class (P < .001), left ventricular systolic ejection time (ET) (P = .002), alkaline phosphatase (P < .001), and aspartate and alanine aminotransferase (P = .003 each). On multivariable analysis, only HF class (hazard ratio [HR] 4.86; 95% confidence interval [CI], 1.58-14.9; P = .006), ET (10 ms increase; HR 0.87; CI, 0.78-0.97; P = .01), and alkaline phosphatase (10 U/L increase; HR 1.04; CI, 1.01-1.06; P = .01) were prognostic. ET <or= 240 ms had a sensitivity of 61% and a specificity of 90% in predicting 1-year mortality and a sensitivity of 73% and a specificity of 90% in predicting 1-year cardiac mortality. CONCLUSION: AL amyloidosis was associated with high long-term mortality. Among echocardiographic and clinical parameters, only ET and alkaline phosphatase had incremental value to HF class in predicting mortality. This may be useful to identify high-risk patients.
OBJECTIVE: Light chain amyloidosis (AL) is associated with high mortality. The aim was to identify echocardiographic parameters that predict AL long-term mortality. METHODS: Forty-two subjects with biopsy-proven AL (43% were female; aged 61 +/- 12 years) underwent echocardiography and were followed 29 +/- 16 months (median 29.4 months). Standard echocardiographic and clinical parameters and heart failure (HF) class were tested using univariate/multivariable Cox proportional hazard regression analyses to identify markers of mortality. RESULTS: Twenty-three subjects died, with a 1-year mortality of 44%. Univariate predictors of mortality were HF class (P < .001), left ventricular systolic ejection time (ET) (P = .002), alkaline phosphatase (P < .001), and aspartate and alanine aminotransferase (P = .003 each). On multivariable analysis, only HF class (hazard ratio [HR] 4.86; 95% confidence interval [CI], 1.58-14.9; P = .006), ET (10 ms increase; HR 0.87; CI, 0.78-0.97; P = .01), and alkaline phosphatase (10 U/L increase; HR 1.04; CI, 1.01-1.06; P = .01) were prognostic. ET <or= 240 ms had a sensitivity of 61% and a specificity of 90% in predicting 1-year mortality and a sensitivity of 73% and a specificity of 90% in predicting 1-year cardiac mortality. CONCLUSION:AL amyloidosis was associated with high long-term mortality. Among echocardiographic and clinical parameters, only ET and alkaline phosphatase had incremental value to HF class in predicting mortality. This may be useful to identify high-risk patients.
Authors: Roberto M Lang; Michelle Bierig; Richard B Devereux; Frank A Flachskampf; Elyse Foster; Patricia A Pellikka; Michael H Picard; Mary J Roman; James Seward; Jack S Shanewise; Scott D Solomon; Kirk T Spencer; Martin St John Sutton; William J Stewart Journal: J Am Soc Echocardiogr Date: 2005-12 Impact factor: 5.251
Authors: E Jantunen; M Itälä; T Lehtinen; O Kuittinen; E Koivunen; S Leppä; E Juvonen; P Koistinen; T Wiklund; T Nousiainen; K Remes; L Volin Journal: Eur J Haematol Date: 2006-01-12 Impact factor: 2.997
Authors: N P Nikitin; P H Loh; R de Silva; J Ghosh; O Y Khaleva; K Goode; A S Rigby; F Alamgir; A L Clark; J G F Cleland Journal: Heart Date: 2005-10-26 Impact factor: 5.994
Authors: David H Vesole; Waleska S Pérez; Marwan Akasheh; Christian Boudreau; Donna E Reece; Christopher N Bredeson Journal: Mayo Clin Proc Date: 2006-07 Impact factor: 7.616
Authors: Thomas Geeraerts; Pierre Albaladejo; Adrien Descorps Declère; Jacques Duranteau; Jean-Patrick Sales; Dan Benhamou Journal: J Trauma Date: 2004-04
Authors: Diego Bellavia; Patricia A Pellikka; Ghormallah B Al-Zahrani; Theodore P Abraham; Angela Dispenzieri; Chinami Miyazaki; Martha Lacy; Christopher G Scott; Jae K Oh; Fletcher A Miller Journal: J Am Soc Echocardiogr Date: 2010-06 Impact factor: 5.251
Authors: Raymond Q Migrino; Seth Truran; David D Gutterman; Daniel A Franco; Megan Bright; Brittany Schlundt; Mitchell Timmons; Angelica Motta; Shane A Phillips; Parameswaran Hari Journal: Am J Physiol Heart Circ Physiol Date: 2011-09-30 Impact factor: 4.733
Authors: Seth Truran; Volkmar Weissig; Marina Ramirez-Alvarado; Daniel A Franco; Camelia Burciu; Joseph Georges; Shishir Murarka; Winter A Okoth; Sara Schwab; Parameswaran Hari; Raymond Q Migrino Journal: J Liposome Res Date: 2013-11-15 Impact factor: 3.648
Authors: Daniel A Franco; Seth Truran; Camelia Burciu; David D Gutterman; Anthony Maltagliati; Volkmar Weissig; Parameswaran Hari; Raymond Q Migrino Journal: Atherosclerosis Date: 2012-09-01 Impact factor: 5.162
Authors: Priyesh A Patel; Andrew P Ambrosy; Matthew Phelan; Fawaz Alenezi; Karen Chiswell; Melissa K Van Dyke; Jennifer Tomfohr; Narimon Honarpour; Eric J Velazquez Journal: Eur J Heart Fail Date: 2019-12-21 Impact factor: 15.534
Authors: Sanjay M Banypersad; James C Moon; Carol Whelan; Philip N Hawkins; Ashutosh D Wechalekar Journal: J Am Heart Assoc Date: 2012-04-24 Impact factor: 5.501