Heart failure & cardiomyopathies
Hemodynamic Profiling and Prognosis in Cardiac Amyloidosis
Authors' conclusion
Hemodynamic variables are grossly abnormal in CA, but elevated filling pressures are prognostic at significantly higher threshold values than classic cutoff values. CI is the hemodynamic variable most strongly associated with outcome and functionality in CA.
Study context
- Population
- Consecutive patients with light chain or transthyretin cardiac amyloidosis undergoing right heart catheterization
- Participants
- 469 patients
- Exposure
- Hemodynamic cutoffs and prognosis
- Outcome
- Combined end point of cardiac transplant/LV assist device and death; HF admissions separately
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Cardiac transplant/LVAD and death
Hazard ratio (CI)P value
Right atrial pressure, classic cutoffdid not identify patients at higher risk
1.26(0.98–1.62)
Mean pulmonary artery pressure, classic cutoffdid not identify patients at higher risk
1.28(0.96–1.71)
Right atrial pressure cutoff 14 mm Hgperformed better to detect worse outcome
1.59(1.26–2.00)
P < 0.05Mean pulmonary artery pressure cutoff 35 mm Hgperformed better to detect worse outcome
1.30(1.01–1.66)
P < 0.05- Reduced CI: strongest variable associated with risk of cardiac transplant/LVAD and death, HF admissions and reduced functional capacity
- 55%
- Reduced CI independently predicted risk on top of Mayo-score (light chain cardiac amyloidosis (CA)) and National Amyloid Center score (transthyretin CA)
- P < 0.05
Observational data: associations, not effects.
Further findings
Prevalence of abnormal hemodynamics
- Elevated right atrial pressure
- 69%
- Elevated pulmonary capillary wedge pressure
- 64%
- Pulmonary hypertension
- 79%
- Reduced cardiac index
- 55%
Light chain vs transthyretin CA hemodynamics
- Light chain CA had higher pulmonary capillary wedge pressure and lower stroke volume index but maintained cardiac index through a higher heart rate
Original publication
Hemodynamic Profiling and Prognosis in Cardiac Amyloidosis. Circ Heart Fail. Published 25 January 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →