Heart failure & cardiomyopathies
Primary Left Atrial Cardiopathy in Transthyretin Amyloidosis Cardiomyopathy by Multimodality Imaging: Implications for Thrombotic Events
Authors' conclusion
Primary LA cardiopathy seems to be associated with TEs in ATTR-CM, independently of AF, CHA2DS2-VASc, and LA dilatation, unlike other LVH phenotypes.
Study context
- Population
- Subjects with speckle tracking echocardiography, Tc-99m pyrophosphate scintigraphy and immune electrophoresis per registry protocolmatched cohort 104:104
- Participants
- 405 subjects
- Exposure
- ATTR-CM vs nonamyloid left ventricular hypertrophy (LVH)
- ATTR-CMn = 149
- LVHn = 165reference
- Outcome
- LA remodeling and its association with thrombotic events
- Follow-up
- 5 years
Methodological detailspropensity-score matched, registry
- Propensity-score matched
- Registry
Main finding
As reported in the abstract
LA remodeling, ATTR-CM vs LVH
- LASr associated with ATTR-CM, independent of diastolic dysfunction and atrial fibrillation (AF)
- OR 1.2; P < 0.001
- Left atrial (LA) stiffness associated with ATTR-CM, independent of diastolic dysfunction and AF
- OR 1.9; P = 0.002
- LASr and LA stiffness independently associated with thrombotic events in ATTR-CM, regardless of CHA2DS2-VASc or prevalent AF
- 20
Observational data: associations, not effects.
Further findings
LASr in ATTR-CM
- LASr correlated poorly with E/e', severely depressed regardless of diastolic dysfunction grade (sinus rhythm), no correlation with LA volume index, unlike LVH
Original publication
Primary Left Atrial Cardiopathy in Transthyretin Amyloidosis Cardiomyopathy by Multimodality Imaging: Implications for Thrombotic Events. JACC Cardiovasc Imaging. Published 3 July 2025. doi:10.
Summarised from the published abstract; every number is checked against it