Diagnostic Value of the Voltage‐to‐Mass Ratio in Biopsy‐Proven Cardiac Amyloidosis

ABSTRACT Objectives The calculation of left ventricular mass varies in different studies, and reference values of the voltage‐to‐mass ratio for diagnosing cardiac amyloidosis (CA) are lacking. This study aimed to determine the value of the voltage‐to‐mass ratio in diagnosing CA and provide an optima...

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Main Authors: Zihan Jiang, Shengsheng Zhuang, Min Tang, Zhuang Tian, Shuyang Zhang
Format: Article
Language:English
Published: Wiley 2024-11-01
Series:Annals of Noninvasive Electrocardiology
Subjects:
Online Access:https://doi.org/10.1111/anec.70026
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author Zihan Jiang
Shengsheng Zhuang
Min Tang
Zhuang Tian
Shuyang Zhang
author_facet Zihan Jiang
Shengsheng Zhuang
Min Tang
Zhuang Tian
Shuyang Zhang
author_sort Zihan Jiang
collection DOAJ
description ABSTRACT Objectives The calculation of left ventricular mass varies in different studies, and reference values of the voltage‐to‐mass ratio for diagnosing cardiac amyloidosis (CA) are lacking. This study aimed to determine the value of the voltage‐to‐mass ratio in diagnosing CA and provide an optimal cut‐off value for different calculation methods. Methods We reviewed the electrocardiograms and echocardiograms of 213 consecutive biopsy‐proven CA patients, 236 hypertrophic cardiomyopathy (HCM) patients, 100 hypertensive heart disease patients, and 181 healthy controls. Left ventricular mass was calculated using linear and cross‐sectional area (CSA) methods. The voltage‐to‐mass ratios were compared between the CA group and other groups. The voltage‐to‐mass ratio obtained was used to build multivariate logistic regression models that predicted the log odds of developing CA. Results The CA group had a significantly lower voltage‐to‐mass ratio than the HCM, hypertensive heart disease, and healthy control groups. The voltage‐to‐mass ratio was an independent factor significantly associated with the CA diagnosis after adjusting for baseline characteristics. Linear and CSA methods yielded areas under the ROC curve of 0.86 and 0.90, respectively. Using the CSA method, the optimal cut‐off was 16.42 mV/mm2/m2, with 89.0% sensitivity and 80.8% specificity. Conclusion The voltage‐to‐mass ratio could differentiate patients with CA, HCM, and hypertensive heart disease from healthy controls, potentially providing an accurate and non‐invasive alternative to current expensive and invasive diagnostic techniques.
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spelling doaj-art-a154e77a9a374b8fa08c7eb672e707f02025-08-20T01:52:37ZengWileyAnnals of Noninvasive Electrocardiology1082-720X1542-474X2024-11-01296n/an/a10.1111/anec.70026Diagnostic Value of the Voltage‐to‐Mass Ratio in Biopsy‐Proven Cardiac AmyloidosisZihan Jiang0Shengsheng Zhuang1Min Tang2Zhuang Tian3Shuyang Zhang4Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences Peking Union Medical College Beijing ChinaDepartment of Cardiology The Xiamen Cardiovascular Hospital of Xiamen University Xiamen ChinaArrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences Peking Union Medical College Beijing ChinaDepartment of International Medical Service, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Cardiology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaABSTRACT Objectives The calculation of left ventricular mass varies in different studies, and reference values of the voltage‐to‐mass ratio for diagnosing cardiac amyloidosis (CA) are lacking. This study aimed to determine the value of the voltage‐to‐mass ratio in diagnosing CA and provide an optimal cut‐off value for different calculation methods. Methods We reviewed the electrocardiograms and echocardiograms of 213 consecutive biopsy‐proven CA patients, 236 hypertrophic cardiomyopathy (HCM) patients, 100 hypertensive heart disease patients, and 181 healthy controls. Left ventricular mass was calculated using linear and cross‐sectional area (CSA) methods. The voltage‐to‐mass ratios were compared between the CA group and other groups. The voltage‐to‐mass ratio obtained was used to build multivariate logistic regression models that predicted the log odds of developing CA. Results The CA group had a significantly lower voltage‐to‐mass ratio than the HCM, hypertensive heart disease, and healthy control groups. The voltage‐to‐mass ratio was an independent factor significantly associated with the CA diagnosis after adjusting for baseline characteristics. Linear and CSA methods yielded areas under the ROC curve of 0.86 and 0.90, respectively. Using the CSA method, the optimal cut‐off was 16.42 mV/mm2/m2, with 89.0% sensitivity and 80.8% specificity. Conclusion The voltage‐to‐mass ratio could differentiate patients with CA, HCM, and hypertensive heart disease from healthy controls, potentially providing an accurate and non‐invasive alternative to current expensive and invasive diagnostic techniques.https://doi.org/10.1111/anec.70026amyloidcardiomyopathyechocardiographyelectrocardiography
spellingShingle Zihan Jiang
Shengsheng Zhuang
Min Tang
Zhuang Tian
Shuyang Zhang
Diagnostic Value of the Voltage‐to‐Mass Ratio in Biopsy‐Proven Cardiac Amyloidosis
Annals of Noninvasive Electrocardiology
amyloid
cardiomyopathy
echocardiography
electrocardiography
title Diagnostic Value of the Voltage‐to‐Mass Ratio in Biopsy‐Proven Cardiac Amyloidosis
title_full Diagnostic Value of the Voltage‐to‐Mass Ratio in Biopsy‐Proven Cardiac Amyloidosis
title_fullStr Diagnostic Value of the Voltage‐to‐Mass Ratio in Biopsy‐Proven Cardiac Amyloidosis
title_full_unstemmed Diagnostic Value of the Voltage‐to‐Mass Ratio in Biopsy‐Proven Cardiac Amyloidosis
title_short Diagnostic Value of the Voltage‐to‐Mass Ratio in Biopsy‐Proven Cardiac Amyloidosis
title_sort diagnostic value of the voltage to mass ratio in biopsy proven cardiac amyloidosis
topic amyloid
cardiomyopathy
echocardiography
electrocardiography
url https://doi.org/10.1111/anec.70026
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AT mintang diagnosticvalueofthevoltagetomassratioinbiopsyprovencardiacamyloidosis
AT zhuangtian diagnosticvalueofthevoltagetomassratioinbiopsyprovencardiacamyloidosis
AT shuyangzhang diagnosticvalueofthevoltagetomassratioinbiopsyprovencardiacamyloidosis