Heart failure & cardiomyopathies
Right Ventricular Function, Clinical Outcomes, and Effect of Vutrisiran in Transthyretin Amyloidosis With Cardiomyopathy: Secondary Analysis of the HELIOS-B Randomized Clinical Trial
Authors' conclusion
RV dysfunction assessed by RVFWS is highly prevalent in ATTR-CM and independently predicts mortality and recurrent CV events, whereas conventional RV measures may underestimate RV dysfunction and lack independent prognostic value. This study found that, consistent with its beneficial effects on other measures of cardiac structure and function, vutrisiran stabilized RVFWS and improved RVFWS/PASP at 30 months.
Study context
- Population
- Patients with ATTR-CM with adequate echocardiographic images548 with adequate images
- Participants
- 655 patients
- Comparison
- Vutrisiran vs placebo
- Primary endpoint
- Composite of:
- All-cause mortality
- Recurrent CV events
Methodological detailspost hoc analysis, Median (IQR) follow-up 36 (33-36) months
- Post hoc analysis
- Median (IQR) follow-up 36 (33-36) months
Primary result
As reported in the abstract
Right ventricular (RV) dysfunction by abnormal RV free wall strain (RVFWS) (absolute RVFWS ≤20%)
85%
RV dysfunction by RV S' (≤9.5cm/s)
56%
RV dysfunction by RV FAC (≤35%)
31%
Further findings
| Outcome | Estimate | |
|---|---|---|
| RVFWS · 30 months · RVFWS stabilized | between-group difference 1.6 % (95% CI 0.7–2.6) | |
| RV FAC · 30 months · no significant effect | difference −1.6 % (95% CI −3.7% to 0.6%) | |
| −4−2024Difference, % (linear scale) |
| Outcome | Between-group difference (%/mm Hg) (95% CI) |
|---|---|
| RVFWS/PASP · 30 months | +0.08 (0.03%/mm Hg to 0.13%/mm Hg) |
Worst RVFWS quartile (<10.8%, n = 137)
- Lower eGFR, lower LVEF and more advanced National Amyloidosis Centre (NAC) stage
Original publication
Summarised from the published abstract; every number is checked against it