Baseline Characteristics Predict the Presence of Amyloid on Endomyocardial Biopsy

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

Research output: Contribution to journalArticle

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

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Amyloidosis
Amyloid
Biopsy
Heart Failure
Peripheral Nervous System Diseases
Survival

Keywords

  • Cardiac amyloid
  • Heart failure
  • Predictors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Baseline Characteristics Predict the Presence of Amyloid on Endomyocardial Biopsy. / Ton, Van Khue; Bhonsale, Aditya; Gilotra, Nisha; Halushka, Marc K; Steenbergen, Charles Jr; Almansa, Johana; Brown, Emily; Tedford, Ryan J.; Wittstein, Ilan S; Sharma, Kavita; Russell, Stuart D.; Judge, Daniel P.

In: Journal of Cardiac Failure, 07.03.2016.

Research output: Contribution to journalArticle

Ton, Van Khue ; Bhonsale, Aditya ; Gilotra, Nisha ; Halushka, Marc K ; Steenbergen, Charles Jr ; Almansa, Johana ; Brown, Emily ; Tedford, Ryan J. ; Wittstein, Ilan S ; Sharma, Kavita ; Russell, Stuart D. ; Judge, Daniel P. / Baseline Characteristics Predict the Presence of Amyloid on Endomyocardial Biopsy. In: Journal of Cardiac Failure. 2016.
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AU - Bhonsale, Aditya

AU - Gilotra, Nisha

AU - Halushka, Marc K

AU - Steenbergen, Charles Jr

AU - Almansa, Johana

AU - Brown, Emily

AU - Tedford, Ryan J.

AU - Wittstein, Ilan S

AU - Sharma, Kavita

AU - Russell, Stuart D.

AU - Judge, Daniel P.

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AB - 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.

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