Abnormal Coronary Flow Velocity Reserve and Decreased Myocardial Contractile Reserve Are Main Factors in Relation to Physical Exercise Capacity in Cardiac Amyloidosis

Clemmensen, Tor Skibsted; Eiskjær, Hans; Mølgaard, Henning; Larsen, Anders Hostrup; Soerensen, Johannes Frasez; Andersen, Niels Frost; Tolbod, Lars Poulsen; Harms, Hendrik J.; Poulsen, Steen Hvitfeldt

doi:10.1016/j.echo.2017.09.007

Cited by 18 publications

(15 citation statements)

References 31 publications

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“…Twenty-eight reports qualified as unique studies for further quantitative analysis [ 19 , 20 , 22 , 40 – 64 ]. Table 1 presents an overview of the characteristics of these studies.…”

Section: Resultsmentioning

confidence: 99%

“…Few studies used autopsies ( n = 5) to identify eligible patients [ 20 , 46 , 61 , 62 , 64 ]. Seventeen studies used endomyocardial biopsy to diagnose at least one patient [ 19 , 20 , 22 , 42 , 43 , 46 , 47 , 50 – 53 , 55 , 56 , 60 – 62 , 64 ], nine studies used either extracardiac biopsy or other diagnostic methods (e.g., scintigraphy) [ 41 , 44 , 45 , 48 , 54 , 57 – 59 , 63 ] and two studies did not report any diagnostic methods [ 40 , 49 ]. Further detailed information on the characteristic of these studies and the quality of individual studies are presented in Supplementary material Table 3 and Supplementary material Table 4, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies reported the proportion of male patients of 50% or less: Tanskanen et al, Shiozaki et al, and Gonzalez et al [ 20 , 62 , 63 ]. On the other hand, four studies included only male patients: Clemmensen et al, Burrage et al, Benson et al and Wilson et al [ 40 , 49 , 55 , 56 ].…”

Section: Resultsmentioning

confidence: 99%

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Estimating the Gender Distribution of Patients with Wild-Type Transthyretin Amyloid Cardiomyopathy: A Systematic Review and Meta-Analysis

Kroi¹,

Fischer

Gezin³

et al. 2020

Cardiol Ther

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Introduction This study investigates the gender distribution in patients diagnosed with wild-type transthyretin amyloidosis cardiomyopathy (ATTRwt). Methods A systematic review and meta-analysis of the male proportion in diagnosed ATTRwt patients were conducted. To avoid overlapping population, pooled estimates in the primary analysis were based on all unique studies. In secondary analyses, we considered predefined subsets of studies based on study sample size, recruitment years, geography, study design, age at diagnosis, and method of diagnosis. Additional meta-regression analyses were tested for potential determinants of gender distribution. Results Twenty-eight unique studies (2542 patients) were included in the meta-analysis. Male proportion in patients with ATTRwt was 86.9% (95% confidence interval 81.5–91.6%). Studies, including patients older than 80 years at diagnosis, had a 29.1% ( p value < 0.001) lower male proportion compared to studies, including younger patients. After adjusting for age, studies using autopsy as a method of diagnosis had a 21.1% ( p value 0.002) lower male proportion compared to other studies. Conclusions Studies conducted to date suggest ATTRwt disproportionally affects males. The proportion of males was significantly impacted by the age at diagnosis and method diagnosis, which may suggest important gender-based differences in the clinical manifestation and diagnostic challenges of ATTRwt in females that warrant future research. Electronic supplementary material The online version of this article (10.1007/s40119-020-00205-3) contains supplementary material, which is available to authorized users.

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“…Twenty-eight reports qualified as unique studies for further quantitative analysis [ 19 , 20 , 22 , 40 – 64 ]. Table 1 presents an overview of the characteristics of these studies.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Estimating the Gender Distribution of Patients with Wild-Type Transthyretin Amyloid Cardiomyopathy: A Systematic Review and Meta-Analysis

Kroi¹,

Fischer

Gezin³

et al. 2020

Cardiol Ther

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“…17 Peak LV systolic mitral annular velocity (LVS 0 ) was estimated from the colour-coded tissue velocity image as an average of septal, lateral, anterior, and posterior velocities. 5,20 Data were analysed offline using dedicated software (EchoPAC PC SW-Only, 113, GE-Healthcare, Milwaukee, Wisconsin, USA) by a single investigator (T. C.) who was blinded to clinical status and invasive measurements. The region of interest was manually adjusted for optimal tracking results.…”

Section: Transthoracic Echocardiographymentioning

confidence: 99%

“…Our group has previously reported repeatability of LVGLS and found a very low intra-observer and inter-observer variation both at rest and during exercise. 5,20 Data were analysed offline using dedicated software (EchoPAC PC SW-Only, 113, GE-Healthcare, Milwaukee, Wisconsin, USA) by a single investigator (T. C.) who was blinded to clinical status and invasive measurements.…”

Section: Transthoracic Echocardiographymentioning

confidence: 99%

Prognostic value of exercise myocardial deformation and haemodynamics in long‐term heart‐transplanted patients

et al. 2019

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Aims The study evaluated exercise left ventricular global longitudinal strain (LVGLS) and invasive haemodynamics for major adverse cardiac events (MACE) prediction in heart‐transplanted (HTx) patients. Methods and results The study comprised 74 stable consecutive HTx patients who were followed at the Department of Cardiology, Aarhus University Hospital, Denmark, from August 2013 to January 2017. All patients were transplanted a minimum of 12 months before study entry and were included at the time of their routine annual coronary angiography. A symptom‐limited haemodynamic exercise test with simultaneous echocardiographic study was performed. The primary endpoint was MACE during follow‐up defined as heart failure hospitalization, treated rejection episodes, coronary event, or cardiac death. The median time since transplant was 5 years [1:12] and the median follow‐up was 1095 days [391;1506]. Thirty patients (41%) experienced MACE during follow‐up. Patients who suffered MACE had an impaired resting and peak exercise systolic function in form of a lower LV ejection fraction (Rest: 56 ± 12% vs. 65 ± 7%, P < 0.001; Peak 64 ± 13% vs. 72 ± 6%, P < 0.01) and LVGLS (Rest: 13 ± 4% vs. 16 ± 2%, P < 0.01; Peak: 15 ± 6% vs. 20 ± 4%, P = 0.0001) than patients without MACE episodes. In contrast, resting diastolic filling patterns were comparable between patients suffering from MACE and patients without MACE. At rest, pulmonary capillary wedge pressure (mPCWP) and cardiac index did not predict MACE, whereas increased right atrial pressure (mRAP) was associated with increased MACE risk. Patients with peak exercise mPCWP >23 mmHg [hazard ratio (HR) 2.5, 95% confidence interval (CI): 1.2–5.4], cardiac index <5.9 L/min/m2 (HR 2.7, 95% CI: 1.0–6.3), or mRAP >13 mmHg (HR 2.7, 95% CI: 1.1–6.3) had increased MACE risk. Patients with exercise‐induced LVGLS increase <3.5% and peak exercise cardiac index <5.9 L/min/m2 [HR 6.1 (95% CI: 2.2–17.1)] or mPCWP >23 mmHg [HR 6.1 (95% CI: 2.1–17.5)] or mRAP >13 mmHg [HR 7.5 (95% CI: 2.3–23.9)] had the highest MACE risk. Conclusions Resting haemodynamic parameters were poor MACE predictors in long‐term HTx patients. In contrast, peak exercise mPCWP, mRAP, and CI were significant MACE predictors. LVGLS both at rest and during exercise were significant MACE predictors, and the combined model with peak exercise LVGLS and peak exercise mPCWP, mRAP, and CI clearly identified high‐risk HTx patients in relation cardiovascular endpoints independently of time since HTx.

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Coronary microvascular disease in hypertrophic and infiltrative cardiomyopathies

Giannopoulos

Buechel

Kaufmann

2023

Journal of Nuclear Cardiology

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Pathologic hypertrophy of the cardiac muscle is a commonly encountered phenotype in clinical practice, associated with a variety of structural and non-structural diseases. Coronary microvascular disease is considered to play an important role in the natural history of this pathological phenotype. Non-invasive imaging modalities, most prominently positron emission tomography and cardiac magnetic resonance, have provided insights into the pathophysiological mechanisms of the interplay between hypertrophy and the coronary microvasculature. This article summarizes the current knowledge on coronary microvascular dysfunction in the most frequently encountered forms of pathologic hypertrophy.

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Abnormal Coronary Flow Velocity Reserve and Decreased Myocardial Contractile Reserve Are Main Factors in Relation to Physical Exercise Capacity in Cardiac Amyloidosis

Cited by 18 publications

References 31 publications

Estimating the Gender Distribution of Patients with Wild-Type Transthyretin Amyloid Cardiomyopathy: A Systematic Review and Meta-Analysis

Estimating the Gender Distribution of Patients with Wild-Type Transthyretin Amyloid Cardiomyopathy: A Systematic Review and Meta-Analysis

Prognostic value of exercise myocardial deformation and haemodynamics in long‐term heart‐transplanted patients

Coronary microvascular disease in hypertrophic and infiltrative cardiomyopathies

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