Valvular & structural heart disease
Histological Assessment of Cardiac Amyloidosis in Patients Undergoing Transcatheter Aortic Valve Replacement
Authors' conclusion
The co-prevalence of AS and CA was lower than expected, at 4.9%. Despite excellent 1 year mortality, AS + CA patients died significantly more often from SCD.
Study context
- Population
- Patients undergoing Transcatheter Aortic Valve Replacement (TAVR) at the University Medical Centre Göttingen, January 2017–March 2021
- Participants
- 162 patients
- Exposure
- Aortic stenosis (AS) + cardiac amyloidosis (CA) vs AS alone
- CAn = 8
- Outcome
- Co-prevalence of AS and CA (histological, endomyocardial biopsy)
Methodological detailsmonocentric, histological (endomyocardial biopsy), pathologist blinded to clinical data
- Monocentric
- Histological (endomyocardial biopsy)
- Pathologist blinded to clinical data
Main finding
As reported in the abstract
Co-prevalence of CA
CA
4.9%
8
Observational data: associations, not effects.
Further findings
NT-proBNP
P = 0.034
Voltage-to-mass ratio
P = 0.022
Mean transaortic gradient (Pmean)
P = 0.004
Serum proteomic biomarkers (propensity-score matched; 184 proteins)
- Lower chymotrypsin in CA
- P = 0.018
- Lower carboxypeptidase 1 in CA
- P = 0.027
- Propensity score matching
Screening algorithm for CA in AS (stroke volume index, EF, N-terminal pro-brain natriuretic peptide (NT-proBNP), posterior wall thickness, QRS voltage-to-mass ratio)
- Sensitivity
- 66.6%
- Specificity
- 98.1%
Safety
Post-procedural AKI
P = 0.018
- SCD · higher with CA
- P = 0.017
Original publication
Histological Assessment of Cardiac Amyloidosis in Patients Undergoing Transcatheter Aortic Valve Replacement. ESC Heart Fail. Published 26 February 2024. doi:10.
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