Left ventricular long axis shortening (LAS) was an independent predictor of 1-year survival in patients with AL amyloidosis (HR 0.72; p<0.0001).
Observational (n=167)
Does semiautomatic quantification of left ventricular long axis shortening (LAS) predict 1-year survival in patients with AL amyloidosis?
Semiautomatic quantification of left ventricular long axis shortening is an independent predictor of 1-year survival in patients with AL amyloidosis, offering incremental prognostic value over traditional echocardiographic parameters and biomarkers.
Estimación del efecto: HR 0.72
valor p: p=<0.0001
AIMS: To assess left ventricular long axis shortening (LAS) in patients with AL amyloidosis as a potential predictor for outcome. METHODS AND RESULTS: We performed a de novo echocardiographic analysis of LAS in 120 patients with biopsy-proven AL amyloidosis evaluated at first presentation before specific treatment. Additionally, 47 control subjects were analyzed retrospectivly. LAS was measured using a semiautomatic tissue motion annular displacement software algorithm (TMAD). LAS was significantly better than ejection fraction (EF) (p < 0.0001) and M-mode-derived mitral annular plane systolic excursion (MAPSE) (p < 0.05) discriminating AL patients from control subjects, while being non-inferior compared to tissue Doppler-derived peak systolic mitral annular velocity. One year outcome analysis in patients with AL amyloidosis showed that LAS remained the only significant echocardiographic parameter (HR:0.76; p < 0.005) in a multivariable Cox regression model of echocardiographic values. In a comprehensive clinical model, LAS (HR:0.72, p < 0.0001), cardiac troponin-T (HR:2.86, p < 0.01) and free light chain difference (HR:1.00; p < 0.05) were independently associated with the outcome. Assessment of LAS led to a significant integrated discrimination improvement and offered incremental information compared to EF and biomarkers. The cut-off value for LAS discriminating the endpoint was 5.8%. CONCLUSION: LAS was an independent predictor of survival within the first year and offers incremental information in patients with AL amyloidosis evaluated prior to specific treatment.
Riffel et al. (Wed,) conducted a observational in Systemic light-chain (AL) amyloidosis (n=167). Semiautomatic quantification of left ventricular long axis shortening (LAS) vs. Ejection fraction (EF) and M-mode-derived MAPSE was evaluated on Survival within the first year (HR 0.72, p=<0.0001). Left ventricular long axis shortening (LAS) was an independent predictor of 1-year survival in patients with AL amyloidosis (HR 0.72; p<0.0001).