Outcomes in Patients With Cardiac Amyloidosis Undergoing Heart Transplantation
The purpose of this study is to report outcomes after heart transplantation in patients with cardiac amyloidosis based on a large single-center experience. Cardiac amyloidosis causes significant morbidity and mortality, often leading to restrictive cardiomyopathy, progressive heart failure, and deat...
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| Veröffentlicht in: | JACC. Heart failure 2020-06, Vol.8 (6), p.461-468 |
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| container_title | JACC. Heart failure |
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| creator | Barrett, Christopher D. Alexander, Kevin M. Zhao, Hongyu Haddad, Francois Cheng, Paul Liao, Ronglih Wheeler, Matthew T. Liedtke, Michaela Schrier, Stanley Arai, Sally Weisshaar, Dana Witteles, Ronald M. |
| description | The purpose of this study is to report outcomes after heart transplantation in patients with cardiac amyloidosis based on a large single-center experience.
Cardiac amyloidosis causes significant morbidity and mortality, often leading to restrictive cardiomyopathy, progressive heart failure, and death. Historically, heart transplantation outcomes have been worse in patients with cardiac amyloidosis compared with other heart failure populations, in part due to the systemic nature of the disease. However, several case series have suggested that transplantation outcomes may be better in the contemporary era, likely in part due to the availability of more effective light chain suppressive therapies for light chain amyloidosis.
This study examined all patients seen between 2004 and 2017, either at the Stanford University Medical Center or the Kaiser Permanente Santa Clara Medical Center, who were diagnosed with cardiac amyloidosis and ultimately underwent heart transplantation. This study examined pre-transplantation characteristics and post-transplantation outcomes in this group compared with the overall transplantation population at our center.
During the study period, 31 patients (13 with light chain amyloidosis and 18 with transthyretin [ATTR] amyloidosis) underwent heart transplantation. Patients with ATTR amyloidosis were older, were more likely to be male, had worse baseline renal function, and had longer waitlist times compared with both patients with light chain amyloidosis and the overall transplantation population. Post-transplantation, there were no differences in post-operative bleeding, renal failure, infection, rejection, or malignancy. There was no significant difference in mortality between patients who underwent heart transplantation for amyloid cardiomyopathy and patients who underwent heart transplantation for all other indications.
In carefully selected patients with cardiac amyloidosis, heart transplantation can be an effective therapeutic option with outcomes similar to those transplanted for other causes of heart failure.
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| doi_str_mv | 10.1016/j.jchf.2019.12.013 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2401116218</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S2213177920300755</els_id><sourcerecordid>2401116218</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-b2d8ae31457cf6fad17f3ff7f8641e97a2ef88d8015ea740b7424211e53de4f43</originalsourceid><addsrcrecordid>eNp9kMFKAzEQhoMoKtoX8CB79NI1k003KXiRolYQ60HxGNJkoindTU1SoW9vSqtHc5kcvv9n5iPkAmgNFNrrRb0wn65mFMY1sJpCc0BOGYNmCEKKw7-_GJ-QQUoLWp4cgZTymJw0rJGCtvKUPM_W2YQOU-X76kVnj31O1bvPn9VER-u1qW67zTJ4G5JP1VtvMX4E339UU9QxV69R92m11H0u2dCfkyOnlwkH-3lG3u7vXifT4dPs4XFy-zQ0nNI8nDMrNTbAR8K41mkLwjXOCSdbDjgWmqGT0koKI9SC07ngjDMAHDUWuePNGbna9a5i-FpjyqrzyeCyLIJhnRTjFABaBrKgbIeaGFKK6NQq-k7HjQKqtirVQm1Vqq1KBUwVlSV0ue9fzzu0f5FfcQW42QFYrvz2GFUyxZ1B6yOarGzw__X_ANgyhNo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2401116218</pqid></control><display><type>article</type><title>Outcomes in Patients With Cardiac Amyloidosis Undergoing Heart Transplantation</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Barrett, Christopher D. ; Alexander, Kevin M. ; Zhao, Hongyu ; Haddad, Francois ; Cheng, Paul ; Liao, Ronglih ; Wheeler, Matthew T. ; Liedtke, Michaela ; Schrier, Stanley ; Arai, Sally ; Weisshaar, Dana ; Witteles, Ronald M.</creator><creatorcontrib>Barrett, Christopher D. ; Alexander, Kevin M. ; Zhao, Hongyu ; Haddad, Francois ; Cheng, Paul ; Liao, Ronglih ; Wheeler, Matthew T. ; Liedtke, Michaela ; Schrier, Stanley ; Arai, Sally ; Weisshaar, Dana ; Witteles, Ronald M.</creatorcontrib><description>The purpose of this study is to report outcomes after heart transplantation in patients with cardiac amyloidosis based on a large single-center experience.
Cardiac amyloidosis causes significant morbidity and mortality, often leading to restrictive cardiomyopathy, progressive heart failure, and death. Historically, heart transplantation outcomes have been worse in patients with cardiac amyloidosis compared with other heart failure populations, in part due to the systemic nature of the disease. However, several case series have suggested that transplantation outcomes may be better in the contemporary era, likely in part due to the availability of more effective light chain suppressive therapies for light chain amyloidosis.
This study examined all patients seen between 2004 and 2017, either at the Stanford University Medical Center or the Kaiser Permanente Santa Clara Medical Center, who were diagnosed with cardiac amyloidosis and ultimately underwent heart transplantation. This study examined pre-transplantation characteristics and post-transplantation outcomes in this group compared with the overall transplantation population at our center.
During the study period, 31 patients (13 with light chain amyloidosis and 18 with transthyretin [ATTR] amyloidosis) underwent heart transplantation. Patients with ATTR amyloidosis were older, were more likely to be male, had worse baseline renal function, and had longer waitlist times compared with both patients with light chain amyloidosis and the overall transplantation population. Post-transplantation, there were no differences in post-operative bleeding, renal failure, infection, rejection, or malignancy. There was no significant difference in mortality between patients who underwent heart transplantation for amyloid cardiomyopathy and patients who underwent heart transplantation for all other indications.
In carefully selected patients with cardiac amyloidosis, heart transplantation can be an effective therapeutic option with outcomes similar to those transplanted for other causes of heart failure.
[Display omitted]</description><identifier>ISSN: 2213-1779</identifier><identifier>EISSN: 2213-1787</identifier><identifier>DOI: 10.1016/j.jchf.2019.12.013</identifier><identifier>PMID: 32387068</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; amyloidosis ; Amyloidosis - complications ; Amyloidosis - diagnosis ; Amyloidosis - surgery ; cardiac amyloidosis ; Cardiomyopathies - complications ; Cardiomyopathies - diagnosis ; Cardiomyopathies - surgery ; Female ; Heart Failure - diagnosis ; Heart Failure - etiology ; Heart Failure - surgery ; Heart Transplantation ; Humans ; infiltrative cardiomyopathy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Waiting Lists</subject><ispartof>JACC. Heart failure, 2020-06, Vol.8 (6), p.461-468</ispartof><rights>2020 American College of Cardiology Foundation</rights><rights>Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-b2d8ae31457cf6fad17f3ff7f8641e97a2ef88d8015ea740b7424211e53de4f43</citedby><cites>FETCH-LOGICAL-c400t-b2d8ae31457cf6fad17f3ff7f8641e97a2ef88d8015ea740b7424211e53de4f43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32387068$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Barrett, Christopher D.</creatorcontrib><creatorcontrib>Alexander, Kevin M.</creatorcontrib><creatorcontrib>Zhao, Hongyu</creatorcontrib><creatorcontrib>Haddad, Francois</creatorcontrib><creatorcontrib>Cheng, Paul</creatorcontrib><creatorcontrib>Liao, Ronglih</creatorcontrib><creatorcontrib>Wheeler, Matthew T.</creatorcontrib><creatorcontrib>Liedtke, Michaela</creatorcontrib><creatorcontrib>Schrier, Stanley</creatorcontrib><creatorcontrib>Arai, Sally</creatorcontrib><creatorcontrib>Weisshaar, Dana</creatorcontrib><creatorcontrib>Witteles, Ronald M.</creatorcontrib><title>Outcomes in Patients With Cardiac Amyloidosis Undergoing Heart Transplantation</title><title>JACC. Heart failure</title><addtitle>JACC Heart Fail</addtitle><description>The purpose of this study is to report outcomes after heart transplantation in patients with cardiac amyloidosis based on a large single-center experience.
Cardiac amyloidosis causes significant morbidity and mortality, often leading to restrictive cardiomyopathy, progressive heart failure, and death. Historically, heart transplantation outcomes have been worse in patients with cardiac amyloidosis compared with other heart failure populations, in part due to the systemic nature of the disease. However, several case series have suggested that transplantation outcomes may be better in the contemporary era, likely in part due to the availability of more effective light chain suppressive therapies for light chain amyloidosis.
This study examined all patients seen between 2004 and 2017, either at the Stanford University Medical Center or the Kaiser Permanente Santa Clara Medical Center, who were diagnosed with cardiac amyloidosis and ultimately underwent heart transplantation. This study examined pre-transplantation characteristics and post-transplantation outcomes in this group compared with the overall transplantation population at our center.
During the study period, 31 patients (13 with light chain amyloidosis and 18 with transthyretin [ATTR] amyloidosis) underwent heart transplantation. Patients with ATTR amyloidosis were older, were more likely to be male, had worse baseline renal function, and had longer waitlist times compared with both patients with light chain amyloidosis and the overall transplantation population. Post-transplantation, there were no differences in post-operative bleeding, renal failure, infection, rejection, or malignancy. There was no significant difference in mortality between patients who underwent heart transplantation for amyloid cardiomyopathy and patients who underwent heart transplantation for all other indications.
In carefully selected patients with cardiac amyloidosis, heart transplantation can be an effective therapeutic option with outcomes similar to those transplanted for other causes of heart failure.
[Display omitted]</description><subject>Aged</subject><subject>amyloidosis</subject><subject>Amyloidosis - complications</subject><subject>Amyloidosis - diagnosis</subject><subject>Amyloidosis - surgery</subject><subject>cardiac amyloidosis</subject><subject>Cardiomyopathies - complications</subject><subject>Cardiomyopathies - diagnosis</subject><subject>Cardiomyopathies - surgery</subject><subject>Female</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - etiology</subject><subject>Heart Failure - surgery</subject><subject>Heart Transplantation</subject><subject>Humans</subject><subject>infiltrative cardiomyopathy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Waiting Lists</subject><issn>2213-1779</issn><issn>2213-1787</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFKAzEQhoMoKtoX8CB79NI1k003KXiRolYQ60HxGNJkoindTU1SoW9vSqtHc5kcvv9n5iPkAmgNFNrrRb0wn65mFMY1sJpCc0BOGYNmCEKKw7-_GJ-QQUoLWp4cgZTymJw0rJGCtvKUPM_W2YQOU-X76kVnj31O1bvPn9VER-u1qW67zTJ4G5JP1VtvMX4E339UU9QxV69R92m11H0u2dCfkyOnlwkH-3lG3u7vXifT4dPs4XFy-zQ0nNI8nDMrNTbAR8K41mkLwjXOCSdbDjgWmqGT0koKI9SC07ngjDMAHDUWuePNGbna9a5i-FpjyqrzyeCyLIJhnRTjFABaBrKgbIeaGFKK6NQq-k7HjQKqtirVQm1Vqq1KBUwVlSV0ue9fzzu0f5FfcQW42QFYrvz2GFUyxZ1B6yOarGzw__X_ANgyhNo</recordid><startdate>202006</startdate><enddate>202006</enddate><creator>Barrett, Christopher D.</creator><creator>Alexander, Kevin M.</creator><creator>Zhao, Hongyu</creator><creator>Haddad, Francois</creator><creator>Cheng, Paul</creator><creator>Liao, Ronglih</creator><creator>Wheeler, Matthew T.</creator><creator>Liedtke, Michaela</creator><creator>Schrier, Stanley</creator><creator>Arai, Sally</creator><creator>Weisshaar, Dana</creator><creator>Witteles, Ronald M.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202006</creationdate><title>Outcomes in Patients With Cardiac Amyloidosis Undergoing Heart Transplantation</title><author>Barrett, Christopher D. ; Alexander, Kevin M. ; Zhao, Hongyu ; Haddad, Francois ; Cheng, Paul ; Liao, Ronglih ; Wheeler, Matthew T. ; Liedtke, Michaela ; Schrier, Stanley ; Arai, Sally ; Weisshaar, Dana ; Witteles, Ronald M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-b2d8ae31457cf6fad17f3ff7f8641e97a2ef88d8015ea740b7424211e53de4f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>amyloidosis</topic><topic>Amyloidosis - complications</topic><topic>Amyloidosis - diagnosis</topic><topic>Amyloidosis - surgery</topic><topic>cardiac amyloidosis</topic><topic>Cardiomyopathies - complications</topic><topic>Cardiomyopathies - diagnosis</topic><topic>Cardiomyopathies - surgery</topic><topic>Female</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - etiology</topic><topic>Heart Failure - surgery</topic><topic>Heart Transplantation</topic><topic>Humans</topic><topic>infiltrative cardiomyopathy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Waiting Lists</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barrett, Christopher D.</creatorcontrib><creatorcontrib>Alexander, Kevin M.</creatorcontrib><creatorcontrib>Zhao, Hongyu</creatorcontrib><creatorcontrib>Haddad, Francois</creatorcontrib><creatorcontrib>Cheng, Paul</creatorcontrib><creatorcontrib>Liao, Ronglih</creatorcontrib><creatorcontrib>Wheeler, Matthew T.</creatorcontrib><creatorcontrib>Liedtke, Michaela</creatorcontrib><creatorcontrib>Schrier, Stanley</creatorcontrib><creatorcontrib>Arai, Sally</creatorcontrib><creatorcontrib>Weisshaar, Dana</creatorcontrib><creatorcontrib>Witteles, Ronald M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>JACC. Heart failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Barrett, Christopher D.</au><au>Alexander, Kevin M.</au><au>Zhao, Hongyu</au><au>Haddad, Francois</au><au>Cheng, Paul</au><au>Liao, Ronglih</au><au>Wheeler, Matthew T.</au><au>Liedtke, Michaela</au><au>Schrier, Stanley</au><au>Arai, Sally</au><au>Weisshaar, Dana</au><au>Witteles, Ronald M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes in Patients With Cardiac Amyloidosis Undergoing Heart Transplantation</atitle><jtitle>JACC. Heart failure</jtitle><addtitle>JACC Heart Fail</addtitle><date>2020-06</date><risdate>2020</risdate><volume>8</volume><issue>6</issue><spage>461</spage><epage>468</epage><pages>461-468</pages><issn>2213-1779</issn><eissn>2213-1787</eissn><abstract>The purpose of this study is to report outcomes after heart transplantation in patients with cardiac amyloidosis based on a large single-center experience.
Cardiac amyloidosis causes significant morbidity and mortality, often leading to restrictive cardiomyopathy, progressive heart failure, and death. Historically, heart transplantation outcomes have been worse in patients with cardiac amyloidosis compared with other heart failure populations, in part due to the systemic nature of the disease. However, several case series have suggested that transplantation outcomes may be better in the contemporary era, likely in part due to the availability of more effective light chain suppressive therapies for light chain amyloidosis.
This study examined all patients seen between 2004 and 2017, either at the Stanford University Medical Center or the Kaiser Permanente Santa Clara Medical Center, who were diagnosed with cardiac amyloidosis and ultimately underwent heart transplantation. This study examined pre-transplantation characteristics and post-transplantation outcomes in this group compared with the overall transplantation population at our center.
During the study period, 31 patients (13 with light chain amyloidosis and 18 with transthyretin [ATTR] amyloidosis) underwent heart transplantation. Patients with ATTR amyloidosis were older, were more likely to be male, had worse baseline renal function, and had longer waitlist times compared with both patients with light chain amyloidosis and the overall transplantation population. Post-transplantation, there were no differences in post-operative bleeding, renal failure, infection, rejection, or malignancy. There was no significant difference in mortality between patients who underwent heart transplantation for amyloid cardiomyopathy and patients who underwent heart transplantation for all other indications.
In carefully selected patients with cardiac amyloidosis, heart transplantation can be an effective therapeutic option with outcomes similar to those transplanted for other causes of heart failure.
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| ispartof | JACC. Heart failure, 2020-06, Vol.8 (6), p.461-468 |
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| subjects | Aged amyloidosis Amyloidosis - complications Amyloidosis - diagnosis Amyloidosis - surgery cardiac amyloidosis Cardiomyopathies - complications Cardiomyopathies - diagnosis Cardiomyopathies - surgery Female Heart Failure - diagnosis Heart Failure - etiology Heart Failure - surgery Heart Transplantation Humans infiltrative cardiomyopathy Male Middle Aged Retrospective Studies Treatment Outcome Waiting Lists |
| title | Outcomes in Patients With Cardiac Amyloidosis Undergoing Heart Transplantation |
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