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Prognostic significance of semiautomatic quantification of left ventricular long axis shortening in systemic light-chain amyloidosis

Aims: To assess left ventricular long axis shortening (LAS) in patients with AL amyloidosis as a potential predictor for outcome.Methods and results: We performed a de novo echocardiographic analysis of LAS in 120 patients with biopsy-proven AL amyloidosis evaluated at first presentation before spec...

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Main Authors: Riffel, Johannes (Author) , Mereles, Derliz (Author) , Emami, Mostafa (Author) , Korosoglou, Grigorios (Author) , Kristen, Arnt (Author) , Aurich, Matthias (Author) , Voß, Andreas (Author) , Schönland, Stefan (Author) , Hegenbart, Ute (Author) , Hardt, Stefan (Author) , Katus, Hugo (Author) , Buß, Sebastian Johannes (Author)
Format: Article (Journal)
Language:English
Published: [2015]
In: Amyloid
Year: 2015, Volume: 22, Issue: 1, Pages: 45-53
ISSN:1744-2818
DOI:10.3109/13506129.2014.992515
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3109/13506129.2014.992515
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Author Notes:Johannes H. Riffel, Derliz Mereles, Mostafa Emami, Grigorios Korosoglou, Arnt V. Kristen, Matthias Aurich, Andreas Voss, Stefan O. Schonland, Ute Hegenbart, Stefan E. Hardt, Hugo A. Katus, and Sebastian J. Buss
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Summary:Aims: To assess left ventricular long axis shortening (LAS) in patients with AL amyloidosis as a potential predictor for outcome.Methods and results: We performed a de novo echocardiographic analysis of LAS in 120 patients with biopsy-proven AL amyloidosis evaluated at first presentation before specific treatment. Additionally, 47 control subjects were analyzed retrospectivly. LAS was measured using a semiautomatic tissue motion annular displacement software algorithm (TMAD). LAS was significantly better than ejection fraction (EF) (p < 0.0001) and M-mode-derived mitral annular plane systolic excursion (MAPSE) (p < 0.05) discriminating AL patients from control subjects, while being non-inferior compared to tissue Doppler-derived peak systolic mitral annular velocity. One year outcome analysis in patients with AL amyloidosis showed that LAS remained the only significant echocardiographic parameter (HR:0.76; p < 0.005) in a multivariable Cox regression model of echocardiographic values. In a comprehensive clinical model, LAS (HR:0.72, p < 0.0001), cardiac troponin-T (HR:2.86, p < 0.01) and free light chain difference (HR:1.00; p < 0.05) were independently associated with the outcome. Assessment of LAS led to a significant integrated discrimination improvement and offered incremental information compared to EF and biomarkers. The cut-off value for LAS discriminating the endpoint was 5.8%.Conclusion: LAS was an independent predictor of survival within the first year and offers incremental information in patients with AL amyloidosis evaluated prior to specific treatment.
Item Description:Published online: 10 Dec 2014
Gesehen am 18.06.2020
Physical Description:Online Resource
ISSN:1744-2818
DOI:10.3109/13506129.2014.992515

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