Heart failure & cardiomyopathiesCohort study
Cardiopulmonary Exercise Testing in Evaluating Transthyretin Amyloidosis
- Cohort study
- single-centre
Authors' conclusion
In this study, ATTR amyloidosis was characterized by distinct patterns of functional impairment between all disease phenotypes. A high prevalence of chronotropic incompetence, EOV, and ventilatory inefficiency were characteristic of this population. CPET parameters were associated with amyloid burden by CMR and with peak VO2, and SBP, which have been shown to be independent predictors of mortality.
Study context
- Population
- Patients with ATTR amyloidosis undergoing cardiopulmonary exercise testing (CPET) at the National Amyloidosis Centre, May 2019 to September 20221,045 approached
- Participants
- 506 patients
- Exposure
- CPET parameters across ATTR amyloidosis phenotypes and amyloid burden
- Outcome
- CPET parameters across disease phenotypes, by amyloid infiltration (CMR with extracellular volume mapping), and association of CPET parameters with prognosis
- Follow-up
- Mean (SD) 22.4 (11.6) months
Main finding
As reported in the abstract
Peak VO2
| Group | Value | Ventilatory efficiency/VCO2 slope, mean (SD) |
|---|---|---|
| ATTR-CM | mean 14.5 (SD 4.3) mL/kg/min | 38.1 (8.6) |
| ATTR-mixed | mean 15.7 (SD 6.2) mL/kg/min |
Observational data: associations, not effects.
Further findings
Prognosis (multivariable Cox regression)
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| Peak VO2 · independently associated with prognosis | 0.89 (0.81–0.99) | P = 0.03 | |
| Peak SBP · independently associated with prognosis | 0.98 (0.97–0.99) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
Original publication
Cardiopulmonary Exercise Testing in Evaluating Transthyretin Amyloidosis. JAMA Cardiol. Published 1 April 2024. doi:10.1001/jamacardio.2024.0022
Summarised from the published abstract; every number is checked against it