Myocardial Contraction Fraction by M-Mode Echocardiography Is Superior to Ejection Fraction in Predicting Mortality in Transthyretin Amyloidosis

Journal of Cardiac Failure
Jonah RubinMathew S Maurer

Abstract

Transthyretin amyloidosis (ATTR) is often associated with cardiac involvement manifesting as conduction disease as well as restrictive cardiomyopathy causing heart failure and death. Myocardial contraction fraction (MCF), the ratio of left ventricular stroke volume (SV) to myocardial volume (MV), is a volumetric measure of myocardial shortening that is superior to ejection fraction (EF) in predicting mortality in patients with primary amyloid light chain cardiac amyloidosis. We hypothesized that MCF would be an independent predictor of survival in TTR-CA. MCF was derived from 2-dimensional echocardiography-guided M-mode data for 530 subjects in the Transthyretin Amyloidosis Outcomes Survey (THAOS) database: age 61 ± 16years, 74% male, 158 wild-type (ATTRwt) and 372 mutant (ATTRm), follow-up 1.5 ± 1.7years. Using multivariate Cox proportional hazard regression models, MCF <25% was highly associated with survival (hazard ratio [HR] 8.5, 95% confidence interval [CI] 4.8-14.9,-P < .0001), which was stronger than the association of EF dichotomized at 50% (HR 2.8, 95% CI 1.8-4.4; P < .0001). MCF <25% remained significantly predictive of survival in a multivariate model that included systolic blood pressure, estimated glomerular filtr...Continue Reading

Associated Clinical Trials

Citations

Apr 17, 2019·European Journal of Heart Failure·Petar M SeferovićCarsten Tschöpe
Jan 18, 2020·European Heart Journal·Liza ChackoMarianna Fontana
Jan 28, 2020·Annual Review of Medicine·Jonah Rubin, Mathew S Maurer
Sep 26, 2020·JACC. Clinical Electrophysiology·Michael R RehornMichel G Khouri
Oct 15, 2020·Open Heart·Aénora Roger-RolléUNKNOWN Toulouse Amyloidosis Research Network collaborators
Mar 20, 2021·Scientific Reports·Constantin-Cristian TopriceanuGabriella Captur
Apr 30, 2021·European Journal of Heart Failure·Pablo Garcia-PaviaPerry M Elliott
Jun 16, 2021·Circulation. Cardiovascular Imaging·Rishi K PatelFrederick L Ruberg
Aug 18, 2021·Circulation. Cardiovascular Imaging·Dan RusinaruChristophe Tribouilloy
Sep 23, 2021·Arquivos brasileiros de cardiologia·Marcus V SimõesEvandro Tinoco Mesquita

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