Key result
Untreated ATTR-CM shows worsening exercise capacity, marked by a ~39-second drop in exercise time.
Why the study?
ATTR-CM is associated with progressive functional capacity reduction, but the progression of CPET parameters over time remains unknown.
How do cardiopulmonary exercise testing parameters change over time in untreated patients with transthyretin cardiac amyloidosis?
Observational (n=55)
No
How do cardiopulmonary exercise testing parameters change over time in untreated patients with transthyretin cardiac amyloidosis?
Effect estimate: -1.29 mL/kg/min (95% CI -1.85 to -0.74)
p-value: p=< 0.01
Serial cardiopulmonary exercise testing can identify early functional decline in untreated ATTR-CM patients before significant echocardiographic changes occur.
May support serial CPET monitoring in untreated ATTR-CM; hypothesis-generating, prospective validation needed before practice change.
BACKGROUND: Transthyretin amyloid cardiomyopathy (ATTR-CM) is associated with a progressive reduction of functional capacity. The progression of cardiopulmonary exercise testing (CPET) parameters over time is still unknown. METHODS: In this study, 55 patients with ATTR-CM underwent 2 serial cardiologic evaluations and CPETs in a national referral center for cardiac amyloidosis (Careggi University Hospital, Florence). RESULTS: slope were significantly worsened (-1.29 mL/kg/min [95% confidence interval (CI): -1.85 to -0.74; P < 0.01], -4.5% [95% CI: -6.9 to -2.02; P < 0.01], and 8.6 [95% CI 6-11; P < 0.01], respectively). Furthermore, exercise time (-39 s, 95% CI: -59 to -19; P < 0.01), exercise tolerance (-0.47 metabolic equivalents, 95% CI: -0.69 to -0.2; P < 0.01), and peak systolic pressure (-10.8 mm Hg, 95% CI: -16.2 to -5.4; P < 0.01) were significantly reduced. The worsening in CPET variables did not correspond with a significant change in echocardiographic parameters. CONCLUSIONS: Cardiorespiratory response to exercise significantly worsened over a short period of time in patients with ATTR-CM. Serial CPET may be useful to identify early disease progression.
No takes yet. Share an insight, caveat, or question.
Argirò et al. (2023) conducted an observational in Transthyretin amyloid cardiomyopathy (ATTR-CM) (n=55). Serial cardiopulmonary exercise testing (CPET) was evaluated on Change in CPET parameters (-1.29 mL/kg/min, 95% CI -1.85 to -0.74, p=< 0.01). Serial cardiopulmonary exercise testing in untreated ATTR-CM patients revealed significant worsening of exercise capacity, including reduced exercise time (-39 s; P<0.01).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: