Identifying Cardiac Amyloid in Aortic Stenosis
Why the study?
Aortic stenosis-amyloid affects 1 in 7 elderly patients referred for TAVR, and noninvasive diagnosis is important as novel treatments for transthyretin-related cardiac amyloid emerge.
Do measures of interstitial expansion (ECV, voltage/mass ratio) improve the detection of cardiac amyloid in patients with aortic stenosis compared to conventional parameters?
Population
Patients with aortic stenosis referred for TAVR
Authors
Discussion
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Member takes
Implication
Hypothesis-generating for voltage/mass ratio in aortic stenosis; prospective validation needed before clinical adoption.
Structured PICO
Do measures of interstitial expansion (ECV, voltage/mass ratio) improve the detection of cardiac amyloid in patients with aortic stenosis compared to conventional parameters?
P
Population
Elderly patients referred for transcatheter aortic valve replacement (TAVR) with aortic stenosis
I
Intervention
Measures of interstitial expansion (extracellular volume [ECV] and voltage/mass ratio)
C
Comparator
Conventional electrocardiogram and echocardiography parameters
O
Outcome
Detection of cardiac amyloidsurrogate
Measures of interstitial expansion, such as the voltage/mass ratio, provide high diagnostic utility for detecting cardiac amyloidosis in patients with aortic stenosis, outperforming conventional ECG and echocardiography.
Limitations
- Voltage/mass ratio could not be calculated in one-third of patients due to bundle branch block or ventricular paced rhythm
Cite This Study
Scully et al. (2020) studied this question.