Associations of Electrocardiographic Parameters with Left Ventricular Longitudinal Strain and Prognosis in Cardiac Light Chain Amyloidosis

Kim, Darae; Lee, Ga Yeon; Choi, Jin-Oh; Kım, Kihyun; Kim, Seok Jin; Jeon, Eun‐Seok

doi:10.1038/s41598-019-44245-9

Cited by 18 publications

(11 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Supplementary Tables 4-6) [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. However, some anatomical differences in cardiac structure were identified (Fig.…”

Section: Sex-related Differences In Demographic and Clinical Charactementioning

confidence: 99%

Transthyretin amyloid cardiomyopathy in women: frequency, characteristics, and diagnostic challenges

et al. 2020

View full text Add to dashboard Cite

Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive, life-threatening disease characterized by deposition of insoluble amyloid fibrils in the myocardium, resulting in cardiac structural and functional abnormalities and ultimately heart failure. Disease frequency is reportedly lower in women than men, but sex-related differences have not been well established. We conducted a systematic literature review (SLR), based on PRISMA-P guidelines and registered with PROSPERO, to assess whether the epidemiology and clinical presentation of ATTR-CM differ between women and men. MEDLINE, Embase, and Cochrane databases and selected conference proceedings were searched (August 16, 2019) to identify observational and clinical studies reporting sex-specific data for patients with wild-type or hereditary ATTR-CM. Of 193 publications satisfying final eligibility criteria, 69 studies were included in our pooled analysis. Among the 4669 patients with ATTR-CM analyzed, 791 (17%) were women, including 174 (9%), 366 (29%), and 251 (18%) in studies of wild-type, hereditary, and undefined ATTR-CM, respectively. Data available on disease characteristics were limited and very heterogeneous, but trends suggested some cardiac structural/functional differences, i.e., lower interventricular septal and posterior wall thickness and left ventricular (LV) end diastolic diameter, and higher LV ejection fractions, in women versus men across ATTR-CM subtypes. Because LV wall thickness > 12 mm is generally the suggested threshold for ATTR-CM diagnosis in both sexes, smaller cardiac anatomy in women with the disease may lead to underdiagnosis. Additional research and studies are needed to elucidate potential disparities between sexes in ATTR-CM frequency, clinical characteristics, and underlying biological mechanisms. This study was registered within the International Prospective Register of Systematic Reviews (PROSPERO) database of the University of York (CRD42019146995).

show abstract

“…Supplementary Tables 4-6) [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. However, some anatomical differences in cardiac structure were identified (Fig.…”

Section: Sex-related Differences In Demographic and Clinical Charactementioning

confidence: 99%

Transthyretin amyloid cardiomyopathy in women: frequency, characteristics, and diagnostic challenges

et al. 2020

View full text Add to dashboard Cite

show abstract

“…A potential mechanism is that the insoluble protein deposits in conduction tissue or within myocardial tissue disrupt normal electromechanical conduction and cause arrhythmias ( 29 ). Previous studies have reported that limb lead and Sokolow voltage measurements ( 17 ), fQRS ( 14 ), and prolonged QTc interval (≥ 483 ms) ( 30 ) are associated significantly with all-cause mortality in AL cardiac amyloidosis. A linear correlation between QRS voltages and ECV has been reported recently by Banypersad et al in a series of 60 patients with AL cardiac amyloidosis ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

Electrocardiogram Characteristics and Prognostic Value in Light-Chain Amyloidosis: A Comparison With Cardiac Magnetic Resonance Imaging

Guo

Chen

Wan

et al. 2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Background: An electrocardiogram (ECG) is a simple and cheap non-invasive tool that shows various abnormalities and has prognostic value for patients with light-chain amyloidosis (AL). The present study aimed to explore the association between ECG characteristics and cardiac magnetic resonance (CMR)-detected amyloid burden and to investigate the prognostic value of ECG in AL amyloidosis.Methods: We prospectively enrolled 99 patients with AL amyloidosis (56 male patients; median age, 58 y). Detailed clinical information, 12-lead ECG, and CMR data were collected. All patients were followed up longitudinally, and the endpoint was all-cause mortality. ECG characteristics were analyzed and correlated with the degree of late gadolinium enhancement (LGE) and extracellular volume (ECV) by T1 mapping on CMR. The prognostic value of ECG characteristics was analyzed using Kaplan–Meier survival analysis and multivariate Cox regression.Results: During a median follow-up period of 33 months, 69 of the 99 patients died. Fragmented Q wave-R wave-S wave (QRS), pathological Q waves, the Sokolow index, QRS duration, and voltages were significantly associated with the extent of LGE, native T1, and ECV by CMR (p < 0.05). Fragmented QRS and Sokolow index showed independent prognostic value in AL amyloidosis (p = 0.001; p = 0.026, respectively). Fragmented QRS remained independent after adjusting for clinical values (hazard ratio: 2.034; 95% confidence interval: 1.148–3.603; p = 0.015). However, no ECG characteristics were independent predictors for prognosis in AL amyloidosis when LGE and ECV were included in the multivariate analysis.Conclusion: ECG abnormalities showed significant association with CMR indicators of amyloid burden. Fragmented QRS has an independent prognostic value in AL amyloidosis and could be used as an alternative marker when CMR is not available.

show abstract

“…In patients with cardiac amyloidosis, low voltage in limb leads, poor R progression, and pseudoinfarction were the most common findings 14‐16 . Low voltage QRS, pseudoinfarction and fragmented QRS was associated with adverse outcomes in cardiac amyloidosis defined by either endomyocardial biopsy or echocardiographic evidence 14,17,18 .…”

Section: Discussionmentioning

confidence: 99%

Electrocardiographic parameters and prognosis of renal light chain amyloidosis

Wang

Lan

et al. 2020

Clinical Cardiology

View full text Add to dashboard Cite

Background: Cardiac involvement frequently occurs in patients with renal light chain (AL) amyloidosis, which predisposes these patients to heart failure, arrhythmia, or infarction with poor prognosis. Hypothesis: Twelve-lead electrocardiogram (ECG) parameters may be associated with prognosis in renal AL amyloidosis. Methods: A retrospective single-center cohort study was performed. Biopsy-proven renal AL amyloidosis patients from January 2014 to December 2018 at the First Affiliated Hospital of Xi'an Jiaotong University were enrolled. The baseline demographic information, laboratory tests, 12-lead ECG parameters at the time of diagnosis were obtained from medical records. The endpoint was defined as the time to all-cause death from baseline for all deceased patients and time to censor date (June 2019) for all other patients. Univariate and multivariate Cox proportional hazard models were conducted to identify the relationship between ECG parameters and all-cause mortality. Results: A total of 69 patients with a mean age of 61.5 ± 11.4 years were enrolled in this study. The median PR interval and QTc interval were 160 (140, 186) and 417 ± 42 ms. The mean follow-up duration was 15.9 ± 13.8 months. Multivariate Cox regression analysis showed that regardless of adjustment for age, gender and serum creatinine, PR interval (HR 1.022, 95% CI: 1.007-1.038, P = .005), and QTc interval (HR 1.012, 95% CI: 1.004-1.021, P = .004) were independently associated with all-cause mortality. Conclusions: PR interval and QTc interval were independently associated with allcause mortality in renal AL amyloidosis patients. ECG parameters may provide prognostic potential of renal AL amyloidosis patients and promote the management of patients with renal AL amyloidosis.

show abstract

Associations of Electrocardiographic Parameters with Left Ventricular Longitudinal Strain and Prognosis in Cardiac Light Chain Amyloidosis

Cited by 18 publications

References 22 publications

Transthyretin amyloid cardiomyopathy in women: frequency, characteristics, and diagnostic challenges

Transthyretin amyloid cardiomyopathy in women: frequency, characteristics, and diagnostic challenges

Electrocardiogram Characteristics and Prognostic Value in Light-Chain Amyloidosis: A Comparison With Cardiac Magnetic Resonance Imaging

Electrocardiographic parameters and prognosis of renal light chain amyloidosis

Contact Info

Product

Resources

About