Left ventriculo-arterial coupling in a contemporary cohort of patients with wild-type transthyretin cardiac amyloidosis treated with tafamidis

BACKGROUND: Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) is characterized by a labile equilibrium between preload and afterload. A tailored approach to supporting medical therapy based on noninvasive parameters able to describe the properties of both heart and systemic vasculature, and their interactions is required. However, data on ventriculo-arterial coupling (VAC) in ATTRwt-CM is lacking. OBJECTIVES: To describe ventriculo-arterial coupling (VAC) and its clinical correlates in a contemporary cohort of patients with ATTRwt-CM. METHODS: ) was evaluated noninvasively using the single-beat algorithm based on arm cuff blood pressure, Doppler stroke volume, pre-ejection time and total ejection time. RESULTS: ratio was an independent determinant of a high NAC/Mondor stage at both univariate (OR[95% CI]:15.39[3.51-67.35], p < 0.001) and multivariate (OR[95% CI]:11.26[1.98-63.81], p = 0.006) logistic regression analyses. CONCLUSION: In ATTRwt-CM patients, arterial and ventricular elastances and VAC are independent predictors of worse clinical status and more advanced disease stage.