| Independent predictors of survival in primary systemic (Al) amyloidosis, including cardiac biomarkers and left ventricular strain imaging: an observational cohort study. | |
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MedLine Citation:
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PMID: 20434879 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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 |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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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:
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Created Date: 2010-05-25 Completed Date: 2010-08-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8801388 Medline TA: J Am Soc Echocardiogr Country: United States |
Other Details:
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Languages: eng Pagination: 643-52 Citation Subset: IM |
Copyright Information:
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Copyright 2010 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Division of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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* |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers |
| Comments/Corrections | |
Comment In:
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J Am Soc Echocardiogr. 2010 Jun;23(6):653-5
[PMID:
20497862
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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