Evaluation of contemporary echocardiographic and histomorphology parameters in predicting mortality in patients with endomyocardial biopsy-proven cardiac AL amyloidosis
IntroductionThis study examined the role of echocardiographic and cardiac histomorphology parameters in predicting mortality in patients with cardiac AL amyloidosis.MethodsPatients with endomyocardial biopsy-proven cardiac AL amyloidosis treated at MD Anderson Cancer Center between 6/2011 and 6/2020...
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| Format: | Article |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1073804/full |
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| author | Efstratios Koutroumpakis Adam Niku Christopher K. Black Abdelrahman Ali Humaira Sadaf Juhee Song Nicolas Palaskas Cezar Iliescu Jean-Bernard Durand Syed Wamique Yusuf Hans C. Lee L. Maximilian Buja Anita Deswal Jose Banchs |
| author_facet | Efstratios Koutroumpakis Adam Niku Christopher K. Black Abdelrahman Ali Humaira Sadaf Juhee Song Nicolas Palaskas Cezar Iliescu Jean-Bernard Durand Syed Wamique Yusuf Hans C. Lee L. Maximilian Buja Anita Deswal Jose Banchs |
| author_sort | Efstratios Koutroumpakis |
| collection | DOAJ |
| description | IntroductionThis study examined the role of echocardiographic and cardiac histomorphology parameters in predicting mortality in patients with cardiac AL amyloidosis.MethodsPatients with endomyocardial biopsy-proven cardiac AL amyloidosis treated at MD Anderson Cancer Center between 6/2011 and 6/2020 were identified. Stored echocardiographic images and endomyocardial biopsy samples were processed for myocardial strain analysis and a detailed histomorphology characterization.ResultsOf 43 patients; 44% were women and 63% white. Median age was 65 years; 51% underwent stem cell transplantation (SCT). Thirty patients (70%) died during follow up (median follow up: 4.1 years). Lower LA strain (<13.5%) and absence of SCT as a time-varying covariate were significantly associated with increased risk of death in the multivariate cox regression analysis. Higher LV mass and lower RV tricuspid annular plane systolic excursion were associated with increased odds of having ≥5% interstitial amyloid deposition on biopsy in the multivariate logistic regression analysis.ConclusionLower LA strain independently predicted mortality in our cohort, and its performance in the routine assessment of AL amyloidosis may be beneficial. Furthermore, SCT for cardiac AL amyloidosis was associated with improved OS. These findings need to be confirmed by larger studies in the era of contemporary systemic therapies. |
| first_indexed | 2024-04-10T20:47:54Z |
| format | Article |
| id | doaj.art-547885b42a0f45d7b272a60ef3dd8d3d |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-10T20:47:54Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-547885b42a0f45d7b272a60ef3dd8d3d2023-01-24T05:22:57ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-01-01910.3389/fcvm.2022.10738041073804Evaluation of contemporary echocardiographic and histomorphology parameters in predicting mortality in patients with endomyocardial biopsy-proven cardiac AL amyloidosisEfstratios Koutroumpakis0Adam Niku1Christopher K. Black2Abdelrahman Ali3Humaira Sadaf4Juhee Song5Nicolas Palaskas6Cezar Iliescu7Jean-Bernard Durand8Syed Wamique Yusuf9Hans C. Lee10L. Maximilian Buja11Anita Deswal12Jose Banchs13Division of Internal Medicine, Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDivision of Internal Medicine, Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDivision of Internal Medicine, Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDivision of Internal Medicine, Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDepartment of Pathology and Laboratory Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, United StatesDepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDivision of Internal Medicine, Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDivision of Internal Medicine, Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDivision of Internal Medicine, Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDivision of Internal Medicine, Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDivision of Cancer Medicine, Department of Lymphoma-Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDepartment of Pathology and Laboratory Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, United StatesDivision of Internal Medicine, Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDivision of Cardiology, University of Colorado School of Medicine, Aurora, CO, United StatesIntroductionThis study examined the role of echocardiographic and cardiac histomorphology parameters in predicting mortality in patients with cardiac AL amyloidosis.MethodsPatients with endomyocardial biopsy-proven cardiac AL amyloidosis treated at MD Anderson Cancer Center between 6/2011 and 6/2020 were identified. Stored echocardiographic images and endomyocardial biopsy samples were processed for myocardial strain analysis and a detailed histomorphology characterization.ResultsOf 43 patients; 44% were women and 63% white. Median age was 65 years; 51% underwent stem cell transplantation (SCT). Thirty patients (70%) died during follow up (median follow up: 4.1 years). Lower LA strain (<13.5%) and absence of SCT as a time-varying covariate were significantly associated with increased risk of death in the multivariate cox regression analysis. Higher LV mass and lower RV tricuspid annular plane systolic excursion were associated with increased odds of having ≥5% interstitial amyloid deposition on biopsy in the multivariate logistic regression analysis.ConclusionLower LA strain independently predicted mortality in our cohort, and its performance in the routine assessment of AL amyloidosis may be beneficial. Furthermore, SCT for cardiac AL amyloidosis was associated with improved OS. These findings need to be confirmed by larger studies in the era of contemporary systemic therapies.https://www.frontiersin.org/articles/10.3389/fcvm.2022.1073804/fullcardiac AL amyloidosisechocardiographyhistomorphologypathologymortalityleft atrial strain (LA strain) |
| spellingShingle | Efstratios Koutroumpakis Adam Niku Christopher K. Black Abdelrahman Ali Humaira Sadaf Juhee Song Nicolas Palaskas Cezar Iliescu Jean-Bernard Durand Syed Wamique Yusuf Hans C. Lee L. Maximilian Buja Anita Deswal Jose Banchs Evaluation of contemporary echocardiographic and histomorphology parameters in predicting mortality in patients with endomyocardial biopsy-proven cardiac AL amyloidosis Frontiers in Cardiovascular Medicine cardiac AL amyloidosis echocardiography histomorphology pathology mortality left atrial strain (LA strain) |
| title | Evaluation of contemporary echocardiographic and histomorphology parameters in predicting mortality in patients with endomyocardial biopsy-proven cardiac AL amyloidosis |
| title_full | Evaluation of contemporary echocardiographic and histomorphology parameters in predicting mortality in patients with endomyocardial biopsy-proven cardiac AL amyloidosis |
| title_fullStr | Evaluation of contemporary echocardiographic and histomorphology parameters in predicting mortality in patients with endomyocardial biopsy-proven cardiac AL amyloidosis |
| title_full_unstemmed | Evaluation of contemporary echocardiographic and histomorphology parameters in predicting mortality in patients with endomyocardial biopsy-proven cardiac AL amyloidosis |
| title_short | Evaluation of contemporary echocardiographic and histomorphology parameters in predicting mortality in patients with endomyocardial biopsy-proven cardiac AL amyloidosis |
| title_sort | evaluation of contemporary echocardiographic and histomorphology parameters in predicting mortality in patients with endomyocardial biopsy proven cardiac al amyloidosis |
| topic | cardiac AL amyloidosis echocardiography histomorphology pathology mortality left atrial strain (LA strain) |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1073804/full |
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