Heart failure & cardiomyopathiesCohort study
Prognostic Utility of Left Atrial Strain to Predict Thrombotic Events and Mortality in Amyloid Cardiomyopathy
- Cohort study
Authors' conclusion
LA strain identifies ACM patients with high thrombotic risk (independent of AF) and improves current ACM-specific survival staging.
Study context
- Population
- Patients with AL or ATTR amyloid cardiomyopathy and no history of atrial fibrillation (AF) at diagnosis50.2% AL
- Participants
- 448 patients
- Exposure
- Left atrial (LA) strain for prediction of thrombotic events and mortality
- Outcome
- Incident thrombotic event and mortality
- Follow-up
- Median 3.8 years
Main finding
As reported in the abstract
Thrombotic event (TE) and mortality, per SD decrease in LA strain
Hazard ratio (95% CI)P value
LA strain reservoir
2.22(1.27–3.85)
P = 0.006LA contractile strain
2.63(1.25–5.00)
P = 0.01Per SD decrease, as printed
HR
- Mortality, per SD decrease in LA strain reservoir
- 1.32 (95% CI: 1.09-1.59; P < 0.001)
- Mortality, per SD decrease in LA contractile strain
- 1.49 (95% CI: 1.22-1.75; P < 0.001)
Observational data: associations, not effects.
Further findings
C-statistic of survival staging systems with LA strain added
- Mayo AL staging: 0.65 to 0.68 (reservoir) and 0.70 (contractile)
- P ≤ 0.02
- Mayo ATTR staging: 0.73 to 0.79 (reservoir) and 0.80 (contractile)
- P < 0.001
- Gillmore ATTR staging: 0.70 to 0.79 (reservoir) and 0.80 (contractile)
- P < 0.001
Original publication
Prognostic Utility of Left Atrial Strain to Predict Thrombotic Events and Mortality in Amyloid Cardiomyopathy. JACC Cardiovasc Imaging. Published 12 April 2023. doi:10.1016/j.jcmg.2023.01.015
Summarised from the published abstract; every number is checked against it