Baseline Characteristics Predict the Presence of Amyloid on Endomyocardial Biopsy

Van Khue Ton, Aditya Bhonsale, Nisha A. Gilotra, Marc K. Halushka, Charles Steenbergen, Johana Almansa, Emily Brown, Ryan Tedford, Ilan Wittstein, Kavita Sharma, Stuart Russell, Daniel P. Judge

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Recent studies have suggested a high prevalence of cardiac amyloidosis (CAm) in heart failure (HF) patients. CAm might be underdiagnosed owing to low clinical suspicion. Methods and Results: We performed retrospective analysis of 259 patients with HF and ejection fraction (EF) ≥50% referred for endomyocardial biopsy. Seventy-three (28%) had CAm. Multivariable independent predictors of CAm were identified. Over a mean follow-up of 2.6 ± 3.3 years, CAm patients had worse survival than those without (1.5 y vs 6.3 y; log rank P < .0001). Conclusions: Clinicians should be suspicious of CAm in patients with EF 50%-75%, >50 years of age, BMI <30 kg/m2, peripheral neuropathy, Sokolow-Lyon index ≤15 mm, and septal wall thickness ≥1.4 cm.

Original languageEnglish (US)
JournalJournal of Cardiac Failure
DOIs
StateAccepted/In press - Mar 7 2016

Keywords

  • Cardiac amyloid
  • Heart failure
  • Predictors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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