Restrictive Atrial Dysfunction in Cardiac Amyloidosis: Differences between Immunoglobulin Light Chain and Transthyretin Cardiac Amyloidosis Patients
<b>Background:</b> In cardiac amyloidosis, the prevalence of thromboembolic events and atrial fibrillation is higher in transthyretin amyloidosis compared to immunoglobulin light chain amyloidosis. Therefore, we hypothesize that transthyretin cardiac amyloidosis patients have worse atria...
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MDPI AG
2022-07-01
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| author | Mathijs O. Versteylen Maaike Brons Arco J. Teske Marish I. F. J. Oerlemans |
| author_facet | Mathijs O. Versteylen Maaike Brons Arco J. Teske Marish I. F. J. Oerlemans |
| author_sort | Mathijs O. Versteylen |
| collection | DOAJ |
| description | <b>Background:</b> In cardiac amyloidosis, the prevalence of thromboembolic events and atrial fibrillation is higher in transthyretin amyloidosis compared to immunoglobulin light chain amyloidosis. Therefore, we hypothesize that transthyretin cardiac amyloidosis patients have worse atrial function. <b>Purpose:</b> To explore the left atrial function by conventional ultrasound and strain analysis in immunoglobulin light chain- and transthyretin cardiac amyloidosis patients. <b>Methods:</b> In cardiac amyloidosis patients in our Amyloidosis Expert Center, echocardiographic strain analysis was performed using speckle tracking. <b>Results:</b> The data of 53 cardiac amyloidosis patients (83% male, mean age 70 years) were analyzed. Transthyretin cardiac amyloidosis patients (<i>n</i> = 24, 45%) were older (75 ± 5.6 vs. 65 ± 7.2 years, <i>p</i> < 0.001) and had more left ventricular (LV) hypertrophy than immunoglobulin light chain cardiac amyloidosis patients (<i>n</i> = 29, 55%). However, LV systolic and diastolic function did not differ, nor did left atrial dimensions (LAVI 56(24) vs. 50(31) mL/m<sup>2</sup>). Left atrial reservoir strain was markedly lower in transthyretin cardiac amyloidosis (7.4(6.2) vs. 13.6(14.7), <i>p</i> = 0.017). This association was independent of other measurements of the left atrial and ventricular function. <b>Conclusions:</b> Transthyretin cardiac amyloidosis patients had lower left atrial reservoir function compared to immunoglobulin light chain cardiac amyloidosis patients although the left atrial geometry was similar. Interestingly, this association was independent of left atrial- and LV ejection fraction and global longitudinal strain. Further research is warranted to assess the impact of impaired left atrial dysfunction in transthyretin cardiac amyloidosis on atrial fibrillation burden and prognosis. |
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| spelling | doaj.art-eb89218ce99d482c9ddbcdc0c553a8cc2023-12-03T13:21:15ZengMDPI AGBiomedicines2227-90592022-07-01108176810.3390/biomedicines10081768Restrictive Atrial Dysfunction in Cardiac Amyloidosis: Differences between Immunoglobulin Light Chain and Transthyretin Cardiac Amyloidosis PatientsMathijs O. Versteylen0Maaike Brons1Arco J. Teske2Marish I. F. J. Oerlemans3Department of Cardiology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The NetherlandsDepartment of Cardiology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The NetherlandsDepartment of Cardiology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The NetherlandsDepartment of Cardiology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands<b>Background:</b> In cardiac amyloidosis, the prevalence of thromboembolic events and atrial fibrillation is higher in transthyretin amyloidosis compared to immunoglobulin light chain amyloidosis. Therefore, we hypothesize that transthyretin cardiac amyloidosis patients have worse atrial function. <b>Purpose:</b> To explore the left atrial function by conventional ultrasound and strain analysis in immunoglobulin light chain- and transthyretin cardiac amyloidosis patients. <b>Methods:</b> In cardiac amyloidosis patients in our Amyloidosis Expert Center, echocardiographic strain analysis was performed using speckle tracking. <b>Results:</b> The data of 53 cardiac amyloidosis patients (83% male, mean age 70 years) were analyzed. Transthyretin cardiac amyloidosis patients (<i>n</i> = 24, 45%) were older (75 ± 5.6 vs. 65 ± 7.2 years, <i>p</i> < 0.001) and had more left ventricular (LV) hypertrophy than immunoglobulin light chain cardiac amyloidosis patients (<i>n</i> = 29, 55%). However, LV systolic and diastolic function did not differ, nor did left atrial dimensions (LAVI 56(24) vs. 50(31) mL/m<sup>2</sup>). Left atrial reservoir strain was markedly lower in transthyretin cardiac amyloidosis (7.4(6.2) vs. 13.6(14.7), <i>p</i> = 0.017). This association was independent of other measurements of the left atrial and ventricular function. <b>Conclusions:</b> Transthyretin cardiac amyloidosis patients had lower left atrial reservoir function compared to immunoglobulin light chain cardiac amyloidosis patients although the left atrial geometry was similar. Interestingly, this association was independent of left atrial- and LV ejection fraction and global longitudinal strain. Further research is warranted to assess the impact of impaired left atrial dysfunction in transthyretin cardiac amyloidosis on atrial fibrillation burden and prognosis.https://www.mdpi.com/2227-9059/10/8/1768cardiac amyloidosisrestrictive atrial dysfunctionatrial strainATTRAL |
| spellingShingle | Mathijs O. Versteylen Maaike Brons Arco J. Teske Marish I. F. J. Oerlemans Restrictive Atrial Dysfunction in Cardiac Amyloidosis: Differences between Immunoglobulin Light Chain and Transthyretin Cardiac Amyloidosis Patients Biomedicines cardiac amyloidosis restrictive atrial dysfunction atrial strain ATTR AL |
| title | Restrictive Atrial Dysfunction in Cardiac Amyloidosis: Differences between Immunoglobulin Light Chain and Transthyretin Cardiac Amyloidosis Patients |
| title_full | Restrictive Atrial Dysfunction in Cardiac Amyloidosis: Differences between Immunoglobulin Light Chain and Transthyretin Cardiac Amyloidosis Patients |
| title_fullStr | Restrictive Atrial Dysfunction in Cardiac Amyloidosis: Differences between Immunoglobulin Light Chain and Transthyretin Cardiac Amyloidosis Patients |
| title_full_unstemmed | Restrictive Atrial Dysfunction in Cardiac Amyloidosis: Differences between Immunoglobulin Light Chain and Transthyretin Cardiac Amyloidosis Patients |
| title_short | Restrictive Atrial Dysfunction in Cardiac Amyloidosis: Differences between Immunoglobulin Light Chain and Transthyretin Cardiac Amyloidosis Patients |
| title_sort | restrictive atrial dysfunction in cardiac amyloidosis differences between immunoglobulin light chain and transthyretin cardiac amyloidosis patients |
| topic | cardiac amyloidosis restrictive atrial dysfunction atrial strain ATTR AL |
| url | https://www.mdpi.com/2227-9059/10/8/1768 |
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