Document Detail


Independent predictors of survival in primary systemic (Al) amyloidosis, including cardiac biomarkers and left ventricular strain imaging: an observational cohort study.
MedLine Citation:
PMID:  20434879     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The prognostic value of Doppler myocardial imaging, including myocardial velocity imaging, strain, and strain rate imaging, in patients with primary (AL) amyloidosis is uncertain. The aim of this longitudinal study was to identify independent predictors of survival, comparing clinical data, hematologic and cardiac biomarkers, and standard echocardiographic and Doppler myocardial imaging measures in a cohort of patients with AL amyloidosis.
METHODS: A total of 249 consecutive patients with AL amyloidosis were prospectively enrolled. The primary end point was all-cause mortality, and during a median follow-up period of 18 months, 75 patients (30%) died. Clinical and electrocardiographic data, biomarkers (brain natriuretic peptide and cardiac troponin T) and standard echocardiographic and longitudinal systolic and diastolic Doppler myocardial imaging measurements for 16 left ventricular segments were tested as potential independent predictors of survival.
RESULTS: Age (hazard ratio [HR], 1.03; P = .03), New York Heart Association class III or IV (HR, 2.47; P = .01), the presence of pleural effusion (HR, 1.79; P = .08), brain natriuretic peptide level (HR, 1.29; P = .01), ejection time (HR, 0.99; P = .13), and peak longitudinal systolic strain of the basal anteroseptal segment (HR, 1.05; P = .02) were independent predictors in the final model.
CONCLUSIONS: Multivariate survival analysis identified independent predictors of clinical outcome in patients with AL amyloidosis: New York Heart Association class III or IV, presence of pleural effusion, brain natriuretic peptide level > 493 pg/mL, ejection time < 273 ms, and peak longitudinal systolic basal anteroseptal strain less negative than or equal to -7.5% defined a high-risk group of patients.
Authors:
Diego Bellavia; Patricia A Pellikka; Ghormallah B Al-Zahrani; Theodore P Abraham; Angela Dispenzieri; Chinami Miyazaki; Martha Lacy; Christopher G Scott; Jae K Oh; Fletcher A Miller
Related Documents :
18971099 - Incremental value of n-terminal pro-brain natriuretic peptide over left ventricle eject...
19926149 - When the heart is burning: amino-terminal pro-brain natriuretic peptide as an early mar...
19027599 - Plasma brain natriuretic peptide concentrations and the risk of cardiovascular events a...
16893709 - Comparison of plasma b-type natriuretic peptide levels in single ventricle patients wit...
19054819 - N-terminal pro-brain natriuretic peptide in systemic sclerosis: a new cornerstone of ca...
15477419 - Prognostic significance of the long pentraxin ptx3 in acute myocardial infarction.
21977279 - Coronary artery disease, left ventricular hypertrophy and diastolic dysfunction are ass...
3553769 - Noncardiac surgery in the patient with heart disease.
10077889 - Therapeutic strategy of perioperative use of percutaneous cardiopulmonary bypass suppor...
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  23     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-25     Completed Date:  2010-08-20     Revised Date:  2014-06-03    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  643-52     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Amyloidosis / blood,  complications,  mortality*
Biological Markers / blood
Echocardiography, Doppler
Female
Humans
Longitudinal Studies
Male
Middle Aged
Prognosis
Prospective Studies
Survival Analysis
Ventricular Dysfunction, Left / blood,  diagnosis*,  etiology,  mortality*
Grant Support
ID/Acronym/Agency:
T32 HL007111/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers
Comments/Corrections
Comment In:
J Am Soc Echocardiogr. 2010 Jun;23(6):653-5   [PMID:  20497862 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Electrical dissociation within the left atrium and left atrial appendage diagnosed with transesophag...
Next Document:  Left Ventricular Contraction-Relaxation Coupling in Normal, Hypertrophic, and Failing Myocardium Qua...