The echocardiographic valve score was significantly higher in patients with ATTR-CA (median 15.8) compared to those with AL-CA (median 11.0, p=0.004) and matched controls.
Case-Control (n=80)
No
Does a comprehensive echocardiographic valve score improve the diagnosis of ATTR-CA in patients with suspected cardiac amyloidosis?
Absolute Event Rate: 15.8% vs 11%
p-value: p=0.004
Cardiac amyloidosis (CA) may affect all cardiac structures, including the valves. From 423 patients undergoing a diagnostic workup for CA we selected 2 samples of 20 patients with amyloid transthyretin (ATTR-) or light-chain (AL-) CA, and age- and sex-matched controls. We chose 31 echocardiographic items related to the mitral, aortic and tricuspid valves, giving a value of 1 to each abnormal item. Patients with ATTR-CA displayed more often a shortened/hidden and restricted posterior mitral valve leaflet (PMVL), thickened mitral chordae tendineae and aortic stenosis than those with AL-CA, and less frequent PMVL calcification than matched controls. Score values were 15.8 (13.6-17.4) in ATTR-CA, 11.0 (9.3-14.9) in AL-CA, 12.8 (11.1-14.4) in ATTR-CA controls, and 11.0 (9.1-13.0) in AL-CA controls (p = 0.004 for ATTR- vs. AL-CA, 0.009 for ATTR-CA vs. their controls, and 0.461 for AL-CA vs. controls). Area under the curve values to diagnose ATTR-CA were 0.782 in patients with ATTR-CA or matched controls, and 0.773 in patients with LV hypertrophy. Patients with ATTR-CA have a prominent impairment of mitral valve structure and function, and higher score values. The valve score may help identify patients with ATTR-CA among patients with CA or unexplained hypertrophy.
Aimo et al. (Wed,) conducted a case-control in Cardiac amyloidosis (n=80). Echocardiographic valve score vs. AL-CA and matched controls was evaluated on Global valve score values (p=0.004). The echocardiographic valve score was significantly higher in patients with ATTR-CA (median 15.8) compared to those with AL-CA (median 11.0, p=0.004) and matched controls.