Prognostic Significance of Holter Monitor Findings in Patients With Light Chain Amyloidosis
To evaluate the prognostic impact of Holter findings in patients with light chain amyloidosis. We evaluated 239 patients in whom light chain amyloidosis was diagnosed from January 1, 2010, through December 31, 2015, who underwent 24-hour Holter monitoring. Holter testing was done before stem cell tr...
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| Veröffentlicht in: | Mayo Clinic proceedings 2019-03, Vol.94 (3), p.455-464 |
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| creator | Sidana, Surbhi Tandon, Nidhi Brady, Peter A. Grogan, Martha Gertz, Morie A. Dispenzieri, Angela Lin, Grace Dingli, David Buadi, Francis K. Lacy, Martha Q. Kapoor, Prashant Gonsalves, Wilson I. Muchtar, Eli Warsame, Rahma Kumar, Shaji K. Kourelis, Taxiarchis V. |
| description | To evaluate the prognostic impact of Holter findings in patients with light chain amyloidosis.
We evaluated 239 patients in whom light chain amyloidosis was diagnosed from January 1, 2010, through December 31, 2015, who underwent 24-hour Holter monitoring.
Holter testing was done before stem cell transplant evaluation in 183 of the 239 patients (76.6%) and at diagnosis in 50 (20.9%). Holter findings were nonsustained ventricular tachycardia (NSVT) in 60 patients (25.1%), ventricular couplets in 103 (43.1)%, accelerated idioventricular rhythm in 32 (13.4%), and atrial fibrillation (AF) in 18 (7.5%). Overall survival (OS) at 3 and 6 months after Holter monitoring in patients with AF vs without AF was 78% (95% CI, 54%-91%) vs 96% (95% CI, 92%-98%) (P=.002) and 61% (95% CI, 38%-80%) vs 92% (95% CI, 87%-95%), (P |
| doi_str_mv | 10.1016/j.mayocp.2018.08.039 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2179516844</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A580774134</galeid><els_id>S0025619618308449</els_id><sourcerecordid>A580774134</sourcerecordid><originalsourceid>FETCH-LOGICAL-c421t-8ab12d6471130bfcb87030215166ca557b487dba52d7ee150bf442960bbf5cba3</originalsourceid><addsrcrecordid>eNp9kdGL1DAQxoMo3nr6H4gEBPGl66RNmuZFWBbPE1Y8UPHBh5CmaZulTfaSVNj_3iw9ffBBGJiH-c03w_ch9JLAlgCp3x23szp7fdqWQJot5KrEI7QhgpYFY7R-jDYAJStqIuor9CzGIwBwIehTdFUBJw1w2KCfd8EPzsdkNf5qB2d7q5XTBvse3_opmYA_e2eTD_jGus66IWLr8J1K1rgU8Q-bRnyww5jwflR5spvPk7edjzY-R096NUXz4qFfo-83H77tb4vDl4-f9rtDoWlJUtGolpRdTTkhFbS9bhsOFZSEkbrWijHe0oZ3rWJlx40hLDOUlqKGtu2ZblV1jd6uuqfg7xcTk5xt1GaalDN-ibIkXGSxhtKMvv4HPfoluPxdpgSDBgSFTL1ZqUFNRo5GTWmMflqS9S7KHcvWcUqqixxdQR18jMH08hTsrMJZEpCXlORRrinJS0oSclUir716-GJpZ9P9XfoTSwber4DJtv2yJsios9_adDYYnWTn7f8v_AZFwKOo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2195080940</pqid></control><display><type>article</type><title>Prognostic Significance of Holter Monitor Findings in Patients With Light Chain Amyloidosis</title><source>Alma/SFX Local Collection</source><creator>Sidana, Surbhi ; Tandon, Nidhi ; Brady, Peter A. ; Grogan, Martha ; Gertz, Morie A. ; Dispenzieri, Angela ; Lin, Grace ; Dingli, David ; Buadi, Francis K. ; Lacy, Martha Q. ; Kapoor, Prashant ; Gonsalves, Wilson I. ; Muchtar, Eli ; Warsame, Rahma ; Kumar, Shaji K. ; Kourelis, Taxiarchis V.</creator><creatorcontrib>Sidana, Surbhi ; Tandon, Nidhi ; Brady, Peter A. ; Grogan, Martha ; Gertz, Morie A. ; Dispenzieri, Angela ; Lin, Grace ; Dingli, David ; Buadi, Francis K. ; Lacy, Martha Q. ; Kapoor, Prashant ; Gonsalves, Wilson I. ; Muchtar, Eli ; Warsame, Rahma ; Kumar, Shaji K. ; Kourelis, Taxiarchis V.</creatorcontrib><description>To evaluate the prognostic impact of Holter findings in patients with light chain amyloidosis.
We evaluated 239 patients in whom light chain amyloidosis was diagnosed from January 1, 2010, through December 31, 2015, who underwent 24-hour Holter monitoring.
Holter testing was done before stem cell transplant evaluation in 183 of the 239 patients (76.6%) and at diagnosis in 50 (20.9%). Holter findings were nonsustained ventricular tachycardia (NSVT) in 60 patients (25.1%), ventricular couplets in 103 (43.1)%, accelerated idioventricular rhythm in 32 (13.4%), and atrial fibrillation (AF) in 18 (7.5%). Overall survival (OS) at 3 and 6 months after Holter monitoring in patients with AF vs without AF was 78% (95% CI, 54%-91%) vs 96% (95% CI, 92%-98%) (P=.002) and 61% (95% CI, 38%-80%) vs 92% (95% CI, 87%-95%), (P<.001), respectively. In patients with and without NSVT, 3- and 6-month OS after Holter testing was 90% (95% CI, 80%-94%) vs 96% (95% CI, 91%-98%) (P=.12) and 77% (95% CI, 64%-85%) vs 94% (95% CI, 89%-97%) (P<.001), respectively. For patients with and without ventricular couplets, 3- and 6-month OS was 94% (95% CI, 88%-97%) vs 94% (95% CI, 89%-97%) (P=.98) and 84% (95% CI, 75%-89%) vs 94% (95% CI, 89%-97%) (P=.01), respectively. Atrial fibrillation (hazard ratio, 2.5; 95% CI, 1.2-5.0; P=.02) and NSVT (hazard ratio, 2.0; 95% CI, 1.1-3.5; P=.02) were independent predictors for OS after accounting for age and Mayo stage. For patients undergoing routine testing before stem cell transplant, AF (P=.002) and NSVT (P=.02) were associated with inferior OS at 6 months but did not retain statistical significance after adjusting for Mayo stage (P=.10 and P=.54, respectively).
Atrial fibrillation and NSVT on 24-hour Holter monitoring are associated with inferior short-term OS outcomes but do not impact peritransplant mortality.</description><identifier>ISSN: 0025-6196</identifier><identifier>EISSN: 1942-5546</identifier><identifier>DOI: 10.1016/j.mayocp.2018.08.039</identifier><identifier>PMID: 30718070</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Ambulatory electrocardiography ; Amyloid ; Amyloidosis ; Analysis ; Arrhythmia ; Atrial fibrillation ; Biomarkers ; Biopsy ; Bone marrow ; Cardiac arrhythmia ; Cardiology ; Cardiomyopathy ; Care and treatment ; Conduction ; Electrocardiography ; Fibrillation ; Fibrosis ; Heart ; Hematology ; Immunoglobulins ; Light ; Medical prognosis ; Medical records ; Medical research ; Mortality ; Patient monitoring equipment ; Patients ; Prognosis ; Stem cell transplantation ; Stem cells ; Survival ; Survival analysis ; Tachycardia ; Task forces ; Transplants & implants ; Ventricle ; Ventricular tachycardia</subject><ispartof>Mayo Clinic proceedings, 2019-03, Vol.94 (3), p.455-464</ispartof><rights>2018 Mayo Foundation for Medical Education and Research</rights><rights>Copyright © 2018 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.</rights><rights>COPYRIGHT 2019 Frontline Medical Communications Inc.</rights><rights>Copyright Mayo Foundation for Medical Education and Research Mar 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c421t-8ab12d6471130bfcb87030215166ca557b487dba52d7ee150bf442960bbf5cba3</citedby><cites>FETCH-LOGICAL-c421t-8ab12d6471130bfcb87030215166ca557b487dba52d7ee150bf442960bbf5cba3</cites><orcidid>0000-0003-2210-2174 ; 0000-0003-3288-7614 ; 0000-0003-0240-0326 ; 0000-0001-7477-3004 ; 0000-0002-3853-5196</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30718070$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sidana, Surbhi</creatorcontrib><creatorcontrib>Tandon, Nidhi</creatorcontrib><creatorcontrib>Brady, Peter A.</creatorcontrib><creatorcontrib>Grogan, Martha</creatorcontrib><creatorcontrib>Gertz, Morie A.</creatorcontrib><creatorcontrib>Dispenzieri, Angela</creatorcontrib><creatorcontrib>Lin, Grace</creatorcontrib><creatorcontrib>Dingli, David</creatorcontrib><creatorcontrib>Buadi, Francis K.</creatorcontrib><creatorcontrib>Lacy, Martha Q.</creatorcontrib><creatorcontrib>Kapoor, Prashant</creatorcontrib><creatorcontrib>Gonsalves, Wilson I.</creatorcontrib><creatorcontrib>Muchtar, Eli</creatorcontrib><creatorcontrib>Warsame, Rahma</creatorcontrib><creatorcontrib>Kumar, Shaji K.</creatorcontrib><creatorcontrib>Kourelis, Taxiarchis V.</creatorcontrib><title>Prognostic Significance of Holter Monitor Findings in Patients With Light Chain Amyloidosis</title><title>Mayo Clinic proceedings</title><addtitle>Mayo Clin Proc</addtitle><description>To evaluate the prognostic impact of Holter findings in patients with light chain amyloidosis.
We evaluated 239 patients in whom light chain amyloidosis was diagnosed from January 1, 2010, through December 31, 2015, who underwent 24-hour Holter monitoring.
Holter testing was done before stem cell transplant evaluation in 183 of the 239 patients (76.6%) and at diagnosis in 50 (20.9%). Holter findings were nonsustained ventricular tachycardia (NSVT) in 60 patients (25.1%), ventricular couplets in 103 (43.1)%, accelerated idioventricular rhythm in 32 (13.4%), and atrial fibrillation (AF) in 18 (7.5%). Overall survival (OS) at 3 and 6 months after Holter monitoring in patients with AF vs without AF was 78% (95% CI, 54%-91%) vs 96% (95% CI, 92%-98%) (P=.002) and 61% (95% CI, 38%-80%) vs 92% (95% CI, 87%-95%), (P<.001), respectively. In patients with and without NSVT, 3- and 6-month OS after Holter testing was 90% (95% CI, 80%-94%) vs 96% (95% CI, 91%-98%) (P=.12) and 77% (95% CI, 64%-85%) vs 94% (95% CI, 89%-97%) (P<.001), respectively. For patients with and without ventricular couplets, 3- and 6-month OS was 94% (95% CI, 88%-97%) vs 94% (95% CI, 89%-97%) (P=.98) and 84% (95% CI, 75%-89%) vs 94% (95% CI, 89%-97%) (P=.01), respectively. Atrial fibrillation (hazard ratio, 2.5; 95% CI, 1.2-5.0; P=.02) and NSVT (hazard ratio, 2.0; 95% CI, 1.1-3.5; P=.02) were independent predictors for OS after accounting for age and Mayo stage. For patients undergoing routine testing before stem cell transplant, AF (P=.002) and NSVT (P=.02) were associated with inferior OS at 6 months but did not retain statistical significance after adjusting for Mayo stage (P=.10 and P=.54, respectively).
Atrial fibrillation and NSVT on 24-hour Holter monitoring are associated with inferior short-term OS outcomes but do not impact peritransplant mortality.</description><subject>Ambulatory electrocardiography</subject><subject>Amyloid</subject><subject>Amyloidosis</subject><subject>Analysis</subject><subject>Arrhythmia</subject><subject>Atrial fibrillation</subject><subject>Biomarkers</subject><subject>Biopsy</subject><subject>Bone marrow</subject><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Cardiomyopathy</subject><subject>Care and treatment</subject><subject>Conduction</subject><subject>Electrocardiography</subject><subject>Fibrillation</subject><subject>Fibrosis</subject><subject>Heart</subject><subject>Hematology</subject><subject>Immunoglobulins</subject><subject>Light</subject><subject>Medical prognosis</subject><subject>Medical records</subject><subject>Medical research</subject><subject>Mortality</subject><subject>Patient monitoring equipment</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Stem cell transplantation</subject><subject>Stem cells</subject><subject>Survival</subject><subject>Survival analysis</subject><subject>Tachycardia</subject><subject>Task forces</subject><subject>Transplants & implants</subject><subject>Ventricle</subject><subject>Ventricular 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Significance of Holter Monitor Findings in Patients With Light Chain Amyloidosis</title><author>Sidana, Surbhi ; Tandon, Nidhi ; Brady, Peter A. ; Grogan, Martha ; Gertz, Morie A. ; Dispenzieri, Angela ; Lin, Grace ; Dingli, David ; Buadi, Francis K. ; Lacy, Martha Q. ; Kapoor, Prashant ; Gonsalves, Wilson I. ; Muchtar, Eli ; Warsame, Rahma ; Kumar, Shaji K. ; Kourelis, Taxiarchis V.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c421t-8ab12d6471130bfcb87030215166ca557b487dba52d7ee150bf442960bbf5cba3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Ambulatory electrocardiography</topic><topic>Amyloid</topic><topic>Amyloidosis</topic><topic>Analysis</topic><topic>Arrhythmia</topic><topic>Atrial fibrillation</topic><topic>Biomarkers</topic><topic>Biopsy</topic><topic>Bone marrow</topic><topic>Cardiac arrhythmia</topic><topic>Cardiology</topic><topic>Cardiomyopathy</topic><topic>Care and treatment</topic><topic>Conduction</topic><topic>Electrocardiography</topic><topic>Fibrillation</topic><topic>Fibrosis</topic><topic>Heart</topic><topic>Hematology</topic><topic>Immunoglobulins</topic><topic>Light</topic><topic>Medical prognosis</topic><topic>Medical records</topic><topic>Medical research</topic><topic>Mortality</topic><topic>Patient monitoring equipment</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Stem cell transplantation</topic><topic>Stem cells</topic><topic>Survival</topic><topic>Survival analysis</topic><topic>Tachycardia</topic><topic>Task forces</topic><topic>Transplants & implants</topic><topic>Ventricle</topic><topic>Ventricular tachycardia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sidana, Surbhi</creatorcontrib><creatorcontrib>Tandon, Nidhi</creatorcontrib><creatorcontrib>Brady, Peter 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Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Mayo Clinic proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sidana, Surbhi</au><au>Tandon, Nidhi</au><au>Brady, Peter A.</au><au>Grogan, Martha</au><au>Gertz, Morie A.</au><au>Dispenzieri, Angela</au><au>Lin, Grace</au><au>Dingli, David</au><au>Buadi, Francis K.</au><au>Lacy, Martha Q.</au><au>Kapoor, Prashant</au><au>Gonsalves, Wilson I.</au><au>Muchtar, Eli</au><au>Warsame, Rahma</au><au>Kumar, Shaji K.</au><au>Kourelis, Taxiarchis V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Significance of Holter Monitor Findings in Patients With Light Chain Amyloidosis</atitle><jtitle>Mayo Clinic proceedings</jtitle><addtitle>Mayo Clin Proc</addtitle><date>2019-03-01</date><risdate>2019</risdate><volume>94</volume><issue>3</issue><spage>455</spage><epage>464</epage><pages>455-464</pages><issn>0025-6196</issn><eissn>1942-5546</eissn><abstract>To evaluate the prognostic impact of Holter findings in patients with light chain amyloidosis.
We evaluated 239 patients in whom light chain amyloidosis was diagnosed from January 1, 2010, through December 31, 2015, who underwent 24-hour Holter monitoring.
Holter testing was done before stem cell transplant evaluation in 183 of the 239 patients (76.6%) and at diagnosis in 50 (20.9%). Holter findings were nonsustained ventricular tachycardia (NSVT) in 60 patients (25.1%), ventricular couplets in 103 (43.1)%, accelerated idioventricular rhythm in 32 (13.4%), and atrial fibrillation (AF) in 18 (7.5%). Overall survival (OS) at 3 and 6 months after Holter monitoring in patients with AF vs without AF was 78% (95% CI, 54%-91%) vs 96% (95% CI, 92%-98%) (P=.002) and 61% (95% CI, 38%-80%) vs 92% (95% CI, 87%-95%), (P<.001), respectively. In patients with and without NSVT, 3- and 6-month OS after Holter testing was 90% (95% CI, 80%-94%) vs 96% (95% CI, 91%-98%) (P=.12) and 77% (95% CI, 64%-85%) vs 94% (95% CI, 89%-97%) (P<.001), respectively. For patients with and without ventricular couplets, 3- and 6-month OS was 94% (95% CI, 88%-97%) vs 94% (95% CI, 89%-97%) (P=.98) and 84% (95% CI, 75%-89%) vs 94% (95% CI, 89%-97%) (P=.01), respectively. Atrial fibrillation (hazard ratio, 2.5; 95% CI, 1.2-5.0; P=.02) and NSVT (hazard ratio, 2.0; 95% CI, 1.1-3.5; P=.02) were independent predictors for OS after accounting for age and Mayo stage. For patients undergoing routine testing before stem cell transplant, AF (P=.002) and NSVT (P=.02) were associated with inferior OS at 6 months but did not retain statistical significance after adjusting for Mayo stage (P=.10 and P=.54, respectively).
Atrial fibrillation and NSVT on 24-hour Holter monitoring are associated with inferior short-term OS outcomes but do not impact peritransplant mortality.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>30718070</pmid><doi>10.1016/j.mayocp.2018.08.039</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-2210-2174</orcidid><orcidid>https://orcid.org/0000-0003-3288-7614</orcidid><orcidid>https://orcid.org/0000-0003-0240-0326</orcidid><orcidid>https://orcid.org/0000-0001-7477-3004</orcidid><orcidid>https://orcid.org/0000-0002-3853-5196</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Mayo Clinic proceedings, 2019-03, Vol.94 (3), p.455-464 |
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| language | eng |
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| source | Alma/SFX Local Collection |
| subjects | Ambulatory electrocardiography Amyloid Amyloidosis Analysis Arrhythmia Atrial fibrillation Biomarkers Biopsy Bone marrow Cardiac arrhythmia Cardiology Cardiomyopathy Care and treatment Conduction Electrocardiography Fibrillation Fibrosis Heart Hematology Immunoglobulins Light Medical prognosis Medical records Medical research Mortality Patient monitoring equipment Patients Prognosis Stem cell transplantation Stem cells Survival Survival analysis Tachycardia Task forces Transplants & implants Ventricle Ventricular tachycardia |
| title | Prognostic Significance of Holter Monitor Findings in Patients With Light Chain Amyloidosis |
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