Associations of Left Atrial Volume Index to Left Ventricular Ejection Fraction Ratio with Clinical Outcomes in Transthyretin Cardiac Amyloidosis
Background: Transthyretin amyloid cardiomyopathy (ATTR-CM) affects all cardiac chambers to cause left ventricular (LV) deformation as well as left atrial (LA) remodeling and functional impairment. We investigated the associations of the LA volume index (LAVI):LV ejection fraction (LVEF) ratio with t...
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MDPI AG
2024-11-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/11/11/363 |
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| author | Yeabsra K. Aleligne Machelle D. Wilson Martin Cadeiras Michael Gibson Shirin Jimenez Stella Yala Pablo E. Acevedo David A. Liem Julie T. Bidwell Imo A. Ebong |
| author_facet | Yeabsra K. Aleligne Machelle D. Wilson Martin Cadeiras Michael Gibson Shirin Jimenez Stella Yala Pablo E. Acevedo David A. Liem Julie T. Bidwell Imo A. Ebong |
| author_sort | Yeabsra K. Aleligne |
| collection | DOAJ |
| description | Background: Transthyretin amyloid cardiomyopathy (ATTR-CM) affects all cardiac chambers to cause left ventricular (LV) deformation as well as left atrial (LA) remodeling and functional impairment. We investigated the associations of the LA volume index (LAVI):LV ejection fraction (LVEF) ratio with the increased risk of death, heart transplant, or LV assist device implantation (LVAD) in patients with ATTR-CM. Methods: This was a retrospective cohort study involving 69 heart failure (HF) patients with ATTR-CM at an academic medical center between 1 November 2008 and 31 March 2024. ATTR-CM was diagnosed using a technetium–diphosphonate/pyrophosphate scan or an endomyocardial biopsy. The LAVI and LVEF were measured by echocardiography. Cox proportional hazards models were used for the analysis. Results: The mean (SD) age of the participants was 77.5 (9.3) years. Over a median (IQR) follow-up period of 1.96 (0.67–2.82) years, we observed 24 composite events that included twenty-two deaths, two heart transplants, and two LVAD implantations (who subsequently died). In multivariable-adjusted analyses that accounted for age and the glomerular filtration rate, a one-unit increase in the LAVI:LVEF ratio was associated with a doubling of the risk (HR, 95% CI: 2.06, 1.11–3.82) of experiencing the composite outcome. Conclusions: A one-unit increase in the LAVI:LVEF ratio was associated with an increased risk of death, heart transplant, or LVAD implantation in patients with ATTR-CM. |
| format | Article |
| id | doaj-art-2e9c337e7c1b47f187a9a3fc62cde36a |
| institution | Kabale University |
| issn | 2308-3425 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-2e9c337e7c1b47f187a9a3fc62cde36a2024-11-26T18:07:25ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252024-11-01111136310.3390/jcdd11110363Associations of Left Atrial Volume Index to Left Ventricular Ejection Fraction Ratio with Clinical Outcomes in Transthyretin Cardiac AmyloidosisYeabsra K. Aleligne0Machelle D. Wilson1Martin Cadeiras2Michael Gibson3Shirin Jimenez4Stella Yala5Pablo E. Acevedo6David A. Liem7Julie T. Bidwell8Imo A. Ebong9Department of Internal Medicine, University of California Davis Health, Sacramento, CA 95817, USADepartment of Public Health Sciences, Division of Biostatistics, University of California Davis, Sacramento, CA 95616, USADivision of Cardiovascular Medicine, University of California Davis Health, Sacramento, CA 95817, USASutter Medical Foundation, Sacramento, CA 95816, USADivision of Cardiovascular Medicine, University of California Davis Health, Sacramento, CA 95817, USADivision of Cardiovascular Medicine, University of California Davis Health, Sacramento, CA 95817, USADivision of Cardiovascular Medicine, University of California Davis Health, Sacramento, CA 95817, USADivision of Cardiovascular Medicine, University of California Davis Health, Sacramento, CA 95817, USABetty Irene Moore School of Nursing, Family Caregiving Institute, University of California Davis, Sacramento, CA 95817, USADivision of Cardiovascular Medicine, University of California Davis Health, Sacramento, CA 95817, USABackground: Transthyretin amyloid cardiomyopathy (ATTR-CM) affects all cardiac chambers to cause left ventricular (LV) deformation as well as left atrial (LA) remodeling and functional impairment. We investigated the associations of the LA volume index (LAVI):LV ejection fraction (LVEF) ratio with the increased risk of death, heart transplant, or LV assist device implantation (LVAD) in patients with ATTR-CM. Methods: This was a retrospective cohort study involving 69 heart failure (HF) patients with ATTR-CM at an academic medical center between 1 November 2008 and 31 March 2024. ATTR-CM was diagnosed using a technetium–diphosphonate/pyrophosphate scan or an endomyocardial biopsy. The LAVI and LVEF were measured by echocardiography. Cox proportional hazards models were used for the analysis. Results: The mean (SD) age of the participants was 77.5 (9.3) years. Over a median (IQR) follow-up period of 1.96 (0.67–2.82) years, we observed 24 composite events that included twenty-two deaths, two heart transplants, and two LVAD implantations (who subsequently died). In multivariable-adjusted analyses that accounted for age and the glomerular filtration rate, a one-unit increase in the LAVI:LVEF ratio was associated with a doubling of the risk (HR, 95% CI: 2.06, 1.11–3.82) of experiencing the composite outcome. Conclusions: A one-unit increase in the LAVI:LVEF ratio was associated with an increased risk of death, heart transplant, or LVAD implantation in patients with ATTR-CM.https://www.mdpi.com/2308-3425/11/11/363cardiac amyloidosistransthyretinclinical outcomesechocardiography |
| spellingShingle | Yeabsra K. Aleligne Machelle D. Wilson Martin Cadeiras Michael Gibson Shirin Jimenez Stella Yala Pablo E. Acevedo David A. Liem Julie T. Bidwell Imo A. Ebong Associations of Left Atrial Volume Index to Left Ventricular Ejection Fraction Ratio with Clinical Outcomes in Transthyretin Cardiac Amyloidosis Journal of Cardiovascular Development and Disease cardiac amyloidosis transthyretin clinical outcomes echocardiography |
| title | Associations of Left Atrial Volume Index to Left Ventricular Ejection Fraction Ratio with Clinical Outcomes in Transthyretin Cardiac Amyloidosis |
| title_full | Associations of Left Atrial Volume Index to Left Ventricular Ejection Fraction Ratio with Clinical Outcomes in Transthyretin Cardiac Amyloidosis |
| title_fullStr | Associations of Left Atrial Volume Index to Left Ventricular Ejection Fraction Ratio with Clinical Outcomes in Transthyretin Cardiac Amyloidosis |
| title_full_unstemmed | Associations of Left Atrial Volume Index to Left Ventricular Ejection Fraction Ratio with Clinical Outcomes in Transthyretin Cardiac Amyloidosis |
| title_short | Associations of Left Atrial Volume Index to Left Ventricular Ejection Fraction Ratio with Clinical Outcomes in Transthyretin Cardiac Amyloidosis |
| title_sort | associations of left atrial volume index to left ventricular ejection fraction ratio with clinical outcomes in transthyretin cardiac amyloidosis |
| topic | cardiac amyloidosis transthyretin clinical outcomes echocardiography |
| url | https://www.mdpi.com/2308-3425/11/11/363 |
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