Prognostic value of cardiopulmonary exercise testing in cardiac amyloidosis

Nicol, Martin; Deney, Antoine; Lairez, Olivier; Vergaro, Giuseppe; Emdin, Michele; Carecci, Alessandro; Inamo, Jocelyn; Montfort, A. P. W. P. van; Nevière, Rémi; Damy, Thibaud; Harel, Stéphanie; Royer, Bruno; Baudet, Mathilde; Cohen‐Solal, Alain; Arnulf, Bertrand; Logeart, Damien

doi:10.1002/ejhf.2016

Cited by 35 publications

(42 citation statements)

References 27 publications

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“…In a recent study on 150 patients with either AL or ATTR CA, peak oxygen consumption (VO 2 ) at cardiopulmonary exercise test was an independent predictor of adverse cardiovascular outcome (all‐cause death or HF hospitalization) as well as peak circulatory power (peak VO 2 × peak systolic blood pressure) and NT‐proBNP. Interestingly, the combination of peak VO 2 <13 mL/kg/min and NT‐proBNP ≥1800 ng/L identified a subgroup of patients at very high risk 112 . Moreover, in this study peak VO 2 alone improved risk stratification over Mayo2012 [net reclassification index (NRI) 0.16] and NAC ATTR staging system (NRI 0.05) in the AL and ATTR CA subgroups, respectively 112 .…”

Section: Biomarkers Of Cardiac Involvementmentioning

confidence: 63%

“…Interestingly, the combination of peak VO 2 <13 mL/kg/min and NT‐proBNP ≥1800 ng/L identified a subgroup of patients at very high risk 112 . Moreover, in this study peak VO 2 alone improved risk stratification over Mayo2012 [net reclassification index (NRI) 0.16] and NAC ATTR staging system (NRI 0.05) in the AL and ATTR CA subgroups, respectively 112 . Another recent study on 309 patients with ATTR CA demonstrated that the addition of diuretic dose (expressed in categories: 0 mg/kg, >0 to 0.5 mg/kg, >0.5 to 1 mg/kg, and >1 to 2 mg/kg) and New York Heart Association (NYHA) class improved the prognostic performance of currently used biomarker‐based staging systems for ATTR CA, namely the NAC ATTR staging system (AUC change from 0.711 to 0.816) and the one proposed by Grogan et al .…”

Section: Biomarkers Of Cardiac Involvementmentioning

confidence: 99%

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Use of biomarkers to diagnose and manage cardiac amyloidosis

Castiglione

Franzini

Aimo

et al. 2021

European J of Heart Fail

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Amyloidoses are characterized by the tissue accumulation of misfolded proteins into insoluble fibrils. The two most common types of systemic amyloidosis result from the deposition of immunoglobulin light chains (AL) and wild-type or variant transthyretin (ATTRwt/ATTRv). Cardiac involvement is the main determinant of outcome in both AL and ATTR, and cardiac amyloidosis (CA) is increasingly recognized as a cause of heart failure. In CA, circulating biomarkers are important diagnostic tools, allow to refine risk stratification at baseline and during follow-up, help to tailor the therapeutic strategy and monitor the response to treatment. Among amyloid precursors, free light chains are established biomarkers in AL amyloidosis, while the plasma transthyretin assay is currently being investigated as a tool for supporting the diagnosis of ATTRv amyloidosis, predicting outcome and monitor response to novel tetramer stabilizers or small interfering RNA drugs in ATTR CA. Natriuretic peptides (NPs) and troponins are consistently elevated in patients with AL and ATTR CA. Plasma NPs, troponins and free light chains hold prognostic significance in AL amyloidosis, and are evaluated for therapy decision-making and follow-up, while the value of NPs and troponins in ATTR is less well established. Biomarkers can be usefully integrated with clinical and imaging variables at all levels of the clinical algorithm of systemic amyloidosis, from screening to diagnosis and prognosis, and treatment tailoring.

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Section: Biomarkers Of Cardiac Involvementmentioning

confidence: 63%

Section: Biomarkers Of Cardiac Involvementmentioning

confidence: 99%

Use of biomarkers to diagnose and manage cardiac amyloidosis

Castiglione

Franzini

Aimo

et al. 2021

European J of Heart Fail

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“…This finding of significant prognostic value of peak CP was also demonstrated in recent study on cardiac amyloid patients. (8) Our study has several limitations. As with other wtATTR studies, the sample size is small due to rarity of the disease.…”

Section: Discussionmentioning

confidence: 91%

Prognostic Role of Cardiopulmonary Exercise Testing in Wild-Type Transthyretin Amyloid Cardiomyopathy Patients Treated With Tafamidis

Dalia

Acharya

Chan

et al. 2021

Journal of Cardiac Failure

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…reviewed the role of circulating biomarkers as tools to guide diagnosis, prognostic stratification, and therapy in CA. The independent prognostic role of cardiopulmonary exercise testing in patients with light chain or transthyretin CA (TTR‐CA) was shown by Nicol et al 5 . in a multicentre study.…”

Section: Cardiac Amyloidosismentioning

confidence: 91%