Evaluation of Prognostic Impact of Left Atrial Longitudinal Strain on Patients with Cardiac Amyloidosis
Abstract
Objectives: Immunoglobulin light chain cardiac amyloidosis (AL) is the most common systemic amyloidosis. Cardiac involvement associated with
poor prognosis and biomarkers are used to determine the prognostic stages. Although echocardiographic parameters are used for the diagnosis of
cardiac involvement, they are not established as the markers of disease severity. We sought to investigate whether left atrial longitudinal strain
parameter predicts survival in patients with cardiac AL amyloidosis.
Materials and Methods: Thirty-seven patients with cardiac amyloidosis were included into our study. Clinical and demographic data and
transthoracic echocardiographic views were obtained from medical records. All patients were divided into two groups according to their survival.
Results: The mean age of the study population was 63.9±10.8 years. Demographic characteristics and laboratory parameters except NT-proBNP were
similar between two groups. NT-proBNP value was found as statistically higher in death caused group (p=0.02). In TTE parameters, the left atrial
volume index was higher (p=0.02) however, peak atrial longitudinal strain (PALS) was reduced in death caused group (p=0.004). In Cox proportional
regression method, PALS was found the most important predictor of survival after adjustment for NT-proBNP [hazard ratio (95% confidence
interval): 0.92 (0.84-0.98); p=0.01].
Conclusion: In our study we determined that PALS was highly associated with survival in patients with cardiac AL amyloidosis. We thought that
larger, prospective studies are necessary to evaluate the prognostic impact of PALS in patients with cardiac AL amyloidosis.
Keywords
Amyloidosis, Immunoglobulin Light Chain, Left Atrial Longitudinal Strain
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