Heart failure & cardiomyopathies
Exercise Limitations in Amyloid Cardiomyopathy Assessed by Cardiopulmonary Exercise Testing—A Multicentre Study
Authors' conclusion
A higher VE/VCO2 slope and an earlier AT, determining functional capacity impairment, was assessed in patients with amyloid cardiomyopathy compared with the matched HF cohort. Additionally, patients with ATTR might display more severe exercise limitations as compared with AL.
Study context
- Population
- Patients with AL or ATTR cardiomyopathy undergoing cardiopulmonary exercise testing at four centres
- Participants
- 267 patients251 matched pairs
- Exposure
- Amyloid cardiomyopathy vs matched heart failure (HF) cohort
- Outcome
- Cardiac output reduction vs ventilation inefficiency as limitation of exercise (CPET parameters)
Methodological detailsmulticentre, propensity-score matched
- Multicentre
- Propensity-score matched
Main finding
As reported in the abstract
CPET parameters, amyloid vs matched HF
| Group | VE/VCO2 slope | NT-proBNP | Peak heart rate | Peak ventilation | VO2 at AT |
|---|---|---|---|---|---|
| Amyloid | 37.4 (IQR 32.7, 43.1) | 2249 (IQR 1187, 4420) ng/L | 121 ± 28 beats/min | 51 (IQR 42, 62) L/min | 8.9 (IQR 6.8, 10.8) mL/min/kg |
| HF | 32.1 (IQR 28.7, 37.0) | 718 (IQR 405, 2161) ng/L | 115 ± 27 beats/min | 43 (IQR 33, 53) L/min | 10.8 (IQR 8.9, 12.7) mL/min/kg |
VE/VCO2 slope
Amyloid37.4 (IQR 32.7, 43.1)
HF32.1 (IQR 28.7, 37.0)
NT-proBNP
Amyloid2249 (IQR 1187, 4420) ng/L
HF718 (IQR 405, 2161) ng/L
Peak heart rate
Amyloid121 ± 28 beats/min
HF115 ± 27 beats/min
Peak ventilation
Amyloid51 (IQR 42, 62) L/min
HF43 (IQR 33, 53) L/min
VO2 at AT
Amyloid8.9 (IQR 6.8, 10.8) mL/min/kg
HF10.8 (IQR 8.9, 12.7) mL/min/kg
- Amyloid vs HF: P < 0.0001 — VE/VCO2 slope
- Amyloid vs HF: P < 0.001 — NT-proBNP
- Amyloid vs HF: P = 0.007 — peak heart rate
- Amyloid vs HF: P < 0.0001 — peak ventilation
- Amyloid vs HF: P < 0.0001 — VO2 at AT
Observational data: associations, not effects.
Further findings
| Outcome | ALn = 27 | ATTRn = 233 | P value |
|---|---|---|---|
| AL vs ATTR (amyloid subgroups) | |||
| Age | 63 (IQR 58, 70) years | 78 (IQR 72, 81) years | P < 0.0001 |
| VE/VCO2 slope | 35.0 (IQR 30.0, 38.7) | 38.0 (IQR 32.8, 43.1) | P = 0.019 |
| PETCO2 at AT | 35.1 ± 4.8 mmHg | 31.4 ± 4.7 mmHg | P < 0.001 |
| PETCO2 at peak | 32 (IQR 28, 35) mmHg | 30 (IQR 26, 33) mmHg | P = 0.039 |
Original publication
Exercise Limitations in Amyloid Cardiomyopathy Assessed by Cardiopulmonary Exercise Testing—A Multicentre Study. ESC Heart Fail. Published 14 November 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →