TY - JOUR
T1 - Prognostic value of left ventricular global constructive work in patients with cardiac amyloidosis
AU - Geers, Jolien
AU - Luchian, Maria-Luiza
AU - Motoc, Andreea
AU - De Winter, Jari
AU - Roosens, Bram
AU - Bjerke, Maria
AU - Van Eeckhaut, Ann
AU - Wittens, Mandy M J
AU - Demeester, Simke
AU - Forsyth, Ramses
AU - de Ravel, Thomy
AU - Bissay, Véronique
AU - Schots, Rik
AU - Verbrugge, Frederik H
AU - Weytjens, Caroline
AU - Weets, Ilse
AU - Cosyns, Bernard
AU - Droogmans, Steven
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature B.V.
Copyright:
Copyright 2023 Elsevier B.V., All rights reserved.
PY - 2023/3
Y1 - 2023/3
N2 - PURPOSE: The aim of the present study was to evaluate the role of ejection fraction (EF), left ventricular (LV) global longitudinal strain (LVGLS) and global constructive work (GCW) as prognostic variables in patients with cardiac amyloidosis (CA).METHODS: CA patients were retrospectively identified between 2015 and 2021 at a tertiary care hospital. Comprehensive clinical, biochemical, and imaging evaluation including two-dimensional (2D) echocardiography with myocardial work (MW) analysis was performed. A clinical combined endpoint was defined as all-cause mortality and heart failure readmission.RESULTS: 70 patients were followed for 16 (7-37) months and 37 (52.9%) reached the combined endpoint. Patient with versus without clinical events had a significantly lower LVEF (40.71% vs. 48.01%, p = 0.039), LVGLS (-9.26 vs. -11.32, p = 0.034) and GCW (1034.47mmHg% vs. 1424.86mmHg%, p = 0.011). Multivariable analysis showed that LVEF ( odds ratio (OR): 0.904; 95% confidence interval (CI): 0.839-0.973, p = 0.007), LVGLS ( OR: 0.620; 95% CI: 0.415-0.926, p = 0.020) and GCW ( OR: 0.995; 95% CI: 0.990-0.999, p = 0.016) were significant predictors of outcome, but the model including GCW had the best discriminative ability to predict the combined endpoint (C-index = 0.888). A GCW less than 1443mmHg% was able to predict the clinical endpoint with a sensitivity of 94% and a specificity of 64% (Area under the curve (AUC): 0.771 (95% CI: 0.581-0.961; p = 0.005)).CONCLUSION: In CA patients, GCW may be of additional prognostic value to LVEF and GLS in predicting heart failure hospitalization and all-cause mortality.
AB - PURPOSE: The aim of the present study was to evaluate the role of ejection fraction (EF), left ventricular (LV) global longitudinal strain (LVGLS) and global constructive work (GCW) as prognostic variables in patients with cardiac amyloidosis (CA).METHODS: CA patients were retrospectively identified between 2015 and 2021 at a tertiary care hospital. Comprehensive clinical, biochemical, and imaging evaluation including two-dimensional (2D) echocardiography with myocardial work (MW) analysis was performed. A clinical combined endpoint was defined as all-cause mortality and heart failure readmission.RESULTS: 70 patients were followed for 16 (7-37) months and 37 (52.9%) reached the combined endpoint. Patient with versus without clinical events had a significantly lower LVEF (40.71% vs. 48.01%, p = 0.039), LVGLS (-9.26 vs. -11.32, p = 0.034) and GCW (1034.47mmHg% vs. 1424.86mmHg%, p = 0.011). Multivariable analysis showed that LVEF ( odds ratio (OR): 0.904; 95% confidence interval (CI): 0.839-0.973, p = 0.007), LVGLS ( OR: 0.620; 95% CI: 0.415-0.926, p = 0.020) and GCW ( OR: 0.995; 95% CI: 0.990-0.999, p = 0.016) were significant predictors of outcome, but the model including GCW had the best discriminative ability to predict the combined endpoint (C-index = 0.888). A GCW less than 1443mmHg% was able to predict the clinical endpoint with a sensitivity of 94% and a specificity of 64% (Area under the curve (AUC): 0.771 (95% CI: 0.581-0.961; p = 0.005)).CONCLUSION: In CA patients, GCW may be of additional prognostic value to LVEF and GLS in predicting heart failure hospitalization and all-cause mortality.
KW - Cardiac amyloidosis
KW - Global constructive work
KW - Left ventricular global longitudinal strain
KW - Myocardial work
UR - http://www.scopus.com/inward/record.url?scp=85146231946&partnerID=8YFLogxK
U2 - 10.1007/s10554-022-02762-1
DO - 10.1007/s10554-022-02762-1
M3 - Article
C2 - 36471103
VL - 39
SP - 585
EP - 593
JO - The International Journal of Cardiovascular Imaging
JF - The International Journal of Cardiovascular Imaging
SN - 1569-5794
IS - 3
ER -