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

Keywords

  • Cardiac amyloid
  • Heart failure
  • Predictors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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