Prognostic Factors and Survival of Chinese Patients with Cardiac Amyloidosis

Purpose. To identify the survival and prognostic factors for cardiac amyloidosis (CA) in Chinese patients. Methods. This was a prospective cohort study of 72 patients diagnosed with CA and admitted to the PLA General Hospital between November 2017 and April 2021. Demographic, clinical, laboratory, electrocardiographic, conventional ultrasound, endocardial LS during LV systole (LV ENDO LSsys), and myocardial strain data were recorded. Survival was assessed. All-cause mortality was the endpoint. Follow-up was censored on September 30, 2021. Results. The mean follow-up was <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mn>17.1</a:mn> <a:mo>±</a:mo> <a:mn>12.9</a:mn> </a:math> months. Among the 72 patients, 39 died, 23 survived, and 10 were lost to follow-up. Mean survival for all patients was <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"> <c:mn>24.7</c:mn> <c:mo>±</c:mo> <c:mn>2.2</c:mn> </c:math> months. Mean survival was <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"> <e:mn>32.7</e:mn> <e:mo>±</e:mo> <e:mn>2.4</e:mn> </e:math> months among patients with NYHA class II, <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"> <g:mn>26.6</g:mn> <g:mo>±</g:mo> <g:mn>3.4</g:mn> </g:math> months for NYHA class III, and <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M5"> <i:mn>5.8</i:mn> <i:mo>±</i:mo> <i:mn>1.1</i:mn> </i:math> months for NYHA class IV. The multivariate Cox proportional hazard regression model showed that NYHA class ( <k:math xmlns:k="http://www.w3.org/1998/Math/MathML" id="M6"> <k:mtext>HR</k:mtext> <k:mo>=</k:mo> <k:mn>3.42</k:mn> </k:math> , 95% CI: 1.36–8.65, <m:math xmlns:m="http://www.w3.org/1998/Math/MathML" id="M7"> <m:mi>P</m:mi> <m:mo>=</m:mo> <m:mn>0.002</m:mn> </m:math> ), log-proBNP level ( <o:math xmlns:o="http://www.w3.org/1998/Math/MathML" id="M8"> <o:mtext>HR</o:mtext> <o:mo>=</o:mo> <o:mn>1.40</o:mn> </o:math> , 95% CI: 1.17–5.83, <q:math xmlns:q="http://www.w3.org/1998/Math/MathML" id="M9"> <q:mi>P</q:mi> <q:mo>=</q:mo> <q:mn>0.03</q:mn> </q:math> ), and ENDO LSsys of the LV basal level ( <s:math xmlns:s="http://www.w3.org/1998/Math/MathML" id="M10"> <s:mtext>HR</s:mtext> <s:mo>=</s:mo> <s:mn>1.25</s:mn> </s:math> , 95% CI: 1.05–1.95, <u:math xmlns:u="http://www.w3.org/1998/Math/MathML" id="M11"> <u:mi>P</u:mi> <u:mo>=</u:mo> <u:mn>0.004</u:mn> </u:math> ) were independent prognostic factors for CA. Conclusion. NYHA class, proBNP level, and ENDO LSsys of the LV basal level were independently associated with the survival of patients with CA.