Heart failure & cardiomyopathies
Progression and Prognostic Significance of Electrocardiographic Findings in Patients with Cardiac Amyloidosis
Main finding · Progression of ECG findingsResult — go to the resultOdds ratio 4.7 95% CI 1.5–15Authors' conclusion
The progression of the ECG abnormalities seems similar across amyloidosis subtypes. QRS duration could be a marker of more advanced disease.
Study context
- Population
- Patients with cardiac amyloidosis (AL, ATTRv, ATTRwt) at six referral centres; median age 76 years, 74% men
- Participants
- 356 patients
- Exposure
- Electrocardiographic (ECG) findings and their progression across cardiac amyloidosis subtypes
- ALn = 105
- ATTRvn = 50
- ATTRwtn = 201reference
- Outcome
- Change in main ECG characteristics and their prognostic role across amyloidosis subtypes
- Follow-up
- Median 15 (8-26) months
Methodological detailsmulticentre, six referral centres
- Multicentre
- Six referral centres
Main finding
Progression of ECG findings
Odds ratio
4.7
95% CI 1.5–15
P < 0.05
AL vs ATTRwt
OR 4.7 (95% CI 1.5–15); P < 0.05
As reported in the abstract
- Adjusted differences in mean PR, QRS interval, total, peripheral and precordial QRS scores similar across subtypes
- P value for linear regression > 0.05
Observational data: associations, not effects.
Further findings
Baseline QRS duration and survival (overall population)
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| QRS duration at baselineAdjusted for relevant clinical variables | 1.78 (1.13–2.8) | P < 0.01 | |
| 0.20.5125Hazard ratio (log scale) |
Baseline low QRS voltage
Baseline T wave inversion
| Outcome | AL | ATTRv | ATTRwt | P value | |
|---|---|---|---|---|---|
| Baseline first-degree atrioventricular blockATTRwt vs AL | 34% | Not reported in the abstract | 40% | P < 0.01 | ATTRv: not reported in the abstract |
| Baseline left bundle branch blockATTRwt vs AL | 2% | Not reported in the abstract | 11% | P < 0.01 | ATTRv: not reported in the abstract |
- Baseline low QRS voltage: P value < 0.01
Original publication
Progression and Prognostic Significance of Electrocardiographic Findings in Patients with Cardiac Amyloidosis. ESC Heart Fail. Published 12 December 2024. doi:10.
Summarised from the published abstract; every number is checked against it