Baseline QRS duration was independently associated with patient survival in cardiac amyloidosis (HR 1.78; 95% CI 1.13-2.8; P<0.01).
Cohort (n=356)
Yes
In patients with cardiac amyloidosis, progression of ECG abnormalities is similar across subtypes, and baseline QRS duration is an independent predictor of survival.
Effect estimate: HR 1.78 (95% CI 1.13-2.8)
p-value: p=<0.01
AIMS: This study aimed to evaluate the change of the main electrocardiographic (ECG) characteristics and their prognostic role across the main subtypes of cardiac amyloidosis light-chain amyloidosis (AL) and hereditary (ATTRv) and wild-type transthyretin amyloidosis (ATTRwt). METHODS AND RESULTS: This multicentre, retrospective study was performed in six referral centres for cardiac amyloidosis. Clinical and ECG data were collected at the first and last evaluations. Three hundred fifty-six patients were included (AL, n = 105; ATTRv, n = 50; ATTRwt, n = 201). The median age was 76 (67-81) years, and 271 (74%) were men. At baseline, patients with ATTRwt showed a higher prevalence of conduction abnormalities compared with those with AL first-degree atrioventricular block, n = 51 (40%) vs. n = 13 (34%), P 0.05). The adjusted odds ratios for the development of right bundle branch block were higher in AL compared with ATTRwt [odds ratio 4.7 (95% confidence interval 1.5-15), P < 0.05. QRS duration at baseline remained independently associated with patient survival in the overall population even after adjustment for relevant clinical variables hazard ratio 1.78 (95% confidence interval 1.13-2.8), P < 0.01. CONCLUSIONS: The progression of the ECG abnormalities seems similar across amyloidosis subtypes. QRS duration could be a marker of more advanced disease.
Argirò et al. (Thu,) conducted a cohort in Cardiac amyloidosis (n=356). Baseline QRS duration and ECG characteristics was evaluated on Patient survival (HR 1.78, 95% CI 1.13-2.8, p=<0.01). Baseline QRS duration was independently associated with patient survival in cardiac amyloidosis (HR 1.78; 95% CI 1.13-2.8; P<0.01).