Differences in the characteristics and contemporary cardiac outcomes of patients with light-chain versus transthyretin cardiac amyloidosis
To compare the baseline cardiovascular characteristics of immunoglobulin light-chain (AL) and amyloid transthyretin (ATTR) cardiac amyloidosis (CA) and to investigate patients' contemporary cardiac outcomes. Single-center analysis of clinical, laboratory, echocardiographic and cardiac magnetic...
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| description | To compare the baseline cardiovascular characteristics of immunoglobulin light-chain (AL) and amyloid transthyretin (ATTR) cardiac amyloidosis (CA) and to investigate patients' contemporary cardiac outcomes. Single-center analysis of clinical, laboratory, echocardiographic and cardiac magnetic resonance imaging (CMRi) characteristics of AL and ATTR-CA patients' cohort (years 2013-2020). Included were 67 CA patients of whom 31 (46%) had AL-CA and 36 (54%) had ATTR-CA. Patients with ATTR-CA versus AL-CA were older (80 (IQR 70, 85) years versus 65 (IQR 60, 71) years, respectively, p |
| doi_str_mv | 10.1371/journal.pone.0255487 |
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Single-center analysis of clinical, laboratory, echocardiographic and cardiac magnetic resonance imaging (CMRi) characteristics of AL and ATTR-CA patients' cohort (years 2013-2020). Included were 67 CA patients of whom 31 (46%) had AL-CA and 36 (54%) had ATTR-CA. Patients with ATTR-CA versus AL-CA were older (80 (IQR 70, 85) years versus 65 (IQR 60, 71) years, respectively, p<0.001) with male predominance (p = 0.038). Co-morbidities in ATTR-CA patients more frequently included diabetes mellitus (19% versus 3.0%, respectively, p = 0.060) and coronary artery disease (39% versus 10%, respectively, p = 0.010). By echocardiography, patients with ATTR-CA versus AL-CA had a trend to worse left ventricular (LV) ejection function (50 (IQR 40, 55)% versus 60 (IQR 45, 60)%, respectively, p = 0.051), yet comparable LV diastolic function. By CMRi, left atrial area (31 (IQR 27, 36)cm.sup.2 vs. 27 (IQR 23, 30)cm.sup.2, respectively, p = 0.015) and LV mass index (109 (IQR 96, 130)grams/m.sup.2 vs. 82 (IQR 72, 98)grams/m.sup.2, respectively, p = 0.011) were increased in patients with ATTR-CA versus AL-CA. Nevertheless, during follow-up (median 20 (IQR 10, 38) months), patients with AL-CA were more frequently admitted with heart failure exacerbations (HR 2.87 (95% CI 1.42, 5.81), p = 0.003) and demonstrated increased mortality (HR 2.51 (95%CI 1.19, 5.28), p = 0.015). Despite the various similarities of AL-CA and ATTR-CA, these diseases have distinct baseline cardiovascular profiles and different heart failure course, thus merit tailored-cardiac management.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0255487</identifier><identifier>PMID: 34370783</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Amyloid ; Amyloidosis ; Biology and Life Sciences ; Biopsy ; Cardiac arrhythmia ; Cardiology ; Cardiovascular disease ; Care and treatment ; Chains ; Congestive heart failure ; Coronary artery ; Coronary artery disease ; Diabetes mellitus ; Echocardiography ; Ejection fraction ; Heart failure ; Kidney diseases ; Laboratories ; Magnetic resonance ; Magnetic resonance imaging ; Medical prognosis ; Medicine ; Medicine and Health Sciences ; Normal distribution ; Patient outcomes ; Patients ; Pulmonary arteries ; Research and Analysis Methods ; Survival analysis ; Transthyretin ; Ventricle</subject><ispartof>PloS one, 2021-08, Vol.16 (8), p.e0255487-e0255487</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Itzhaki Ben Zadok et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Itzhaki Ben Zadok et al 2021 Itzhaki Ben Zadok et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c669t-991a770683e48f4d86bc2edf2da6386d7c6d2a55bba84315234c230595e2d1683</citedby><cites>FETCH-LOGICAL-c669t-991a770683e48f4d86bc2edf2da6386d7c6d2a55bba84315234c230595e2d1683</cites><orcidid>0000-0002-9259-4808</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8351987/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8351987/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2929,23868,27926,27927,53793,53795</link.rule.ids></links><search><contributor>Lionetti, Vincenzo</contributor><creatorcontrib>Itzhaki Ben Zadok, Osnat</creatorcontrib><creatorcontrib>Vaturi, Mordehay</creatorcontrib><creatorcontrib>Vaxman, Iuliana</creatorcontrib><creatorcontrib>Iakobishvili, Zaza</creatorcontrib><creatorcontrib>Rhurman-Shahar, Noa</creatorcontrib><creatorcontrib>Kornowski, Ran</creatorcontrib><creatorcontrib>Hamdan, Ashraf</creatorcontrib><title>Differences in the characteristics and contemporary cardiac outcomes of patients with light-chain versus transthyretin cardiac amyloidosis</title><title>PloS one</title><description>To compare the baseline cardiovascular characteristics of immunoglobulin light-chain (AL) and amyloid transthyretin (ATTR) cardiac amyloidosis (CA) and to investigate patients' contemporary cardiac outcomes. Single-center analysis of clinical, laboratory, echocardiographic and cardiac magnetic resonance imaging (CMRi) characteristics of AL and ATTR-CA patients' cohort (years 2013-2020). Included were 67 CA patients of whom 31 (46%) had AL-CA and 36 (54%) had ATTR-CA. Patients with ATTR-CA versus AL-CA were older (80 (IQR 70, 85) years versus 65 (IQR 60, 71) years, respectively, p<0.001) with male predominance (p = 0.038). Co-morbidities in ATTR-CA patients more frequently included diabetes mellitus (19% versus 3.0%, respectively, p = 0.060) and coronary artery disease (39% versus 10%, respectively, p = 0.010). By echocardiography, patients with ATTR-CA versus AL-CA had a trend to worse left ventricular (LV) ejection function (50 (IQR 40, 55)% versus 60 (IQR 45, 60)%, respectively, p = 0.051), yet comparable LV diastolic function. By CMRi, left atrial area (31 (IQR 27, 36)cm.sup.2 vs. 27 (IQR 23, 30)cm.sup.2, respectively, p = 0.015) and LV mass index (109 (IQR 96, 130)grams/m.sup.2 vs. 82 (IQR 72, 98)grams/m.sup.2, respectively, p = 0.011) were increased in patients with ATTR-CA versus AL-CA. Nevertheless, during follow-up (median 20 (IQR 10, 38) months), patients with AL-CA were more frequently admitted with heart failure exacerbations (HR 2.87 (95% CI 1.42, 5.81), p = 0.003) and demonstrated increased mortality (HR 2.51 (95%CI 1.19, 5.28), p = 0.015). Despite the various similarities of AL-CA and ATTR-CA, these diseases have distinct baseline cardiovascular profiles and different heart failure course, thus merit tailored-cardiac management.</description><subject>Amyloid</subject><subject>Amyloidosis</subject><subject>Biology and Life Sciences</subject><subject>Biopsy</subject><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Care and treatment</subject><subject>Chains</subject><subject>Congestive heart failure</subject><subject>Coronary artery</subject><subject>Coronary artery disease</subject><subject>Diabetes mellitus</subject><subject>Echocardiography</subject><subject>Ejection fraction</subject><subject>Heart failure</subject><subject>Kidney diseases</subject><subject>Laboratories</subject><subject>Magnetic resonance</subject><subject>Magnetic resonance imaging</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Normal distribution</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Pulmonary arteries</subject><subject>Research and Analysis Methods</subject><subject>Survival 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in the characteristics and contemporary cardiac outcomes of patients with light-chain versus transthyretin cardiac amyloidosis</title><author>Itzhaki Ben Zadok, Osnat ; Vaturi, Mordehay ; Vaxman, Iuliana ; Iakobishvili, Zaza ; Rhurman-Shahar, Noa ; Kornowski, Ran ; Hamdan, Ashraf</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c669t-991a770683e48f4d86bc2edf2da6386d7c6d2a55bba84315234c230595e2d1683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Amyloid</topic><topic>Amyloidosis</topic><topic>Biology and Life Sciences</topic><topic>Biopsy</topic><topic>Cardiac arrhythmia</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Care and treatment</topic><topic>Chains</topic><topic>Congestive heart failure</topic><topic>Coronary artery</topic><topic>Coronary artery disease</topic><topic>Diabetes mellitus</topic><topic>Echocardiography</topic><topic>Ejection fraction</topic><topic>Heart failure</topic><topic>Kidney diseases</topic><topic>Laboratories</topic><topic>Magnetic resonance</topic><topic>Magnetic resonance imaging</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Normal distribution</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Pulmonary arteries</topic><topic>Research and Analysis Methods</topic><topic>Survival analysis</topic><topic>Transthyretin</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Itzhaki Ben Zadok, Osnat</creatorcontrib><creatorcontrib>Vaturi, Mordehay</creatorcontrib><creatorcontrib>Vaxman, Iuliana</creatorcontrib><creatorcontrib>Iakobishvili, Zaza</creatorcontrib><creatorcontrib>Rhurman-Shahar, Noa</creatorcontrib><creatorcontrib>Kornowski, Ran</creatorcontrib><creatorcontrib>Hamdan, 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one</jtitle><date>2021-08-09</date><risdate>2021</risdate><volume>16</volume><issue>8</issue><spage>e0255487</spage><epage>e0255487</epage><pages>e0255487-e0255487</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To compare the baseline cardiovascular characteristics of immunoglobulin light-chain (AL) and amyloid transthyretin (ATTR) cardiac amyloidosis (CA) and to investigate patients' contemporary cardiac outcomes. Single-center analysis of clinical, laboratory, echocardiographic and cardiac magnetic resonance imaging (CMRi) characteristics of AL and ATTR-CA patients' cohort (years 2013-2020). Included were 67 CA patients of whom 31 (46%) had AL-CA and 36 (54%) had ATTR-CA. Patients with ATTR-CA versus AL-CA were older (80 (IQR 70, 85) years versus 65 (IQR 60, 71) years, respectively, p<0.001) with male predominance (p = 0.038). Co-morbidities in ATTR-CA patients more frequently included diabetes mellitus (19% versus 3.0%, respectively, p = 0.060) and coronary artery disease (39% versus 10%, respectively, p = 0.010). By echocardiography, patients with ATTR-CA versus AL-CA had a trend to worse left ventricular (LV) ejection function (50 (IQR 40, 55)% versus 60 (IQR 45, 60)%, respectively, p = 0.051), yet comparable LV diastolic function. By CMRi, left atrial area (31 (IQR 27, 36)cm.sup.2 vs. 27 (IQR 23, 30)cm.sup.2, respectively, p = 0.015) and LV mass index (109 (IQR 96, 130)grams/m.sup.2 vs. 82 (IQR 72, 98)grams/m.sup.2, respectively, p = 0.011) were increased in patients with ATTR-CA versus AL-CA. Nevertheless, during follow-up (median 20 (IQR 10, 38) months), patients with AL-CA were more frequently admitted with heart failure exacerbations (HR 2.87 (95% CI 1.42, 5.81), p = 0.003) and demonstrated increased mortality (HR 2.51 (95%CI 1.19, 5.28), p = 0.015). Despite the various similarities of AL-CA and ATTR-CA, these diseases have distinct baseline cardiovascular profiles and different heart failure course, thus merit tailored-cardiac management.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>34370783</pmid><doi>10.1371/journal.pone.0255487</doi><tpages>e0255487</tpages><orcidid>https://orcid.org/0000-0002-9259-4808</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Amyloid Amyloidosis Biology and Life Sciences Biopsy Cardiac arrhythmia Cardiology Cardiovascular disease Care and treatment Chains Congestive heart failure Coronary artery Coronary artery disease Diabetes mellitus Echocardiography Ejection fraction Heart failure Kidney diseases Laboratories Magnetic resonance Magnetic resonance imaging Medical prognosis Medicine Medicine and Health Sciences Normal distribution Patient outcomes Patients Pulmonary arteries Research and Analysis Methods Survival analysis Transthyretin Ventricle |
| title | Differences in the characteristics and contemporary cardiac outcomes of patients with light-chain versus transthyretin cardiac amyloidosis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-18T08%3A54%3A08IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Differences%20in%20the%20characteristics%20and%20contemporary%20cardiac%20outcomes%20of%20patients%20with%20light-chain%20versus%20transthyretin%20cardiac%20amyloidosis&rft.jtitle=PloS%20one&rft.au=Itzhaki%20Ben%20Zadok,%20Osnat&rft.date=2021-08-09&rft.volume=16&rft.issue=8&rft.spage=e0255487&rft.epage=e0255487&rft.pages=e0255487-e0255487&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0255487&rft_dat=%3Cgale_plos_%3EA671258344%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2559640614&rft_id=info:pmid/34370783&rft_galeid=A671258344&rft_doaj_id=oai_doaj_org_article_8a75674fbb9f41b089c966c5010f2e5c&rfr_iscdi=true |