[An analysis of factors affecting the prognosis of patients with cardiac amyloidosis]

Zhonghua Nei Ke Za Zhi. 2013 Apr;52(4):305-8.
[Article in Chinese]

Abstract

Objective: To analyze the clinical characteristics, diagnosis, treatment and outcome of patients with cardiac amyloidosis (CA).

Methods: Clinical data from 18 patients diagnosed as CA by endomyocardial biopsy (EMB) from 1995 to 2005 were retrospectively analyzed.

Results: Among the 18 patients with CA, all patients had reduced diastolic dysfunction; 12 had mitral valve early diastolic blood flow peak velocity/late diastolic blood flow peak velocity (E/A) > 2.0 and ventricular diastolic early filling deceleration time (DT) < 150 ms; 12 had left ventricular ejection fraction (LVEF) < 50%; and 13 had New York Heart Association (NYHA) classification III or IV. The 1-year, 3-year and 5-year survival rates of 18 patients with CA were 67%, 44% and 17%, respectively. Kaplan-Meier analysis showed, NYHA functional class > II, E/A > 2.0 and DT < 150 ms were associated with increased mortality (log-rank statistic P = 0.026 and 0.001, respectively). CA patients with chemotherapy before heart failure were associated with decreased mortality and extend survival.

Conclusions: The mortality rate goes up and survival rate gradually descends as prolonged onset time. NYHA functional class >IIand E/A > 2.0 (DT< 150 ms) are associated with mortality.

MeSH terms

  • Aged
  • Amyloidosis / mortality
  • Amyloidosis / pathology*
  • Biopsy
  • Cardiac Catheterization
  • Cardiomyopathies
  • Diastole / physiology
  • Echocardiography, Doppler
  • Heart Failure / diagnostic imaging
  • Heart Failure / mortality
  • Heart Failure / physiopathology*
  • Humans
  • Kaplan-Meier Estimate
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / physiopathology
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Ventricular Dysfunction, Left / physiopathology*
  • Ventricular Function, Left