Cardiac Resynchronization Therapy, Remodeling, and Outcome in Patients With Amyloid Transthyretin Cardiomyopathy.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Aimo Alberto, Nesti Martina, Vergaro Giuseppe, Killu Ammar M, Bampatsias Dimitrios, Tomasoni Daniela, Forleo Cinzia, Musca Francesco, Serenelli Matteo, Rosenthal Julie, Teruya Sergio L, Al-Shakarchi Nader J, Tameze Mariel S, Castiglione Vincenzo, Nicolai Alessio, Panichella Giorgia, Saro Riccardo, Porcari Aldostefano, Sinigiani Giulio, Fico Vera, Frau Elisa, Matar Reem, Guaricci Andrea I, Tini Giacomo, Cipriani Alberto, Musumeci Maria B, Longhi Simone, Chimenti Cristina, Metra Marco, Grogan Martha, Perfetto Federico, Cappelli Francesco, Merlo Marco, Sinagra Gianfranco, Maurer Mathew S, Masri Ahmad, Emdin Michele
Аннотация
METHODS: In this multicenter, observational study, patients with ATTR-CM receiving CRT (n=101) were matched to patients without amyloid cardiomyopathy by sex, age, and implantation type (CRT with versus without defibrillator versus conduction system pacing, upgrade versus first implant). We evaluated changes in QRS duration and echocardiographic parameters following CRT implantation and at the most recent available assessments. The study end points were all-cause death alone or combined with heart failure hospitalization.
RESULTS: Patients with ATTR-CM (median age, 76 [interquartile range, 72-83] years, 98% men, left ventricular (LV) ejection fraction 30% [26-33]) showed greater QRS shortening after CRT implantation (P=0.012), but not after a median of around 1 year (P=0.152). There were no significant differences in the absolute LV ejection fraction changes immediately after implantation (+7 [+2/+10] versus +3 [0/+9] units; P=0.124), or to the last echo (P=0.796), which was performed after 1.3 years in patients with ATTR-CM and 2.9 years in patients without amyloid cardiomyopathy. Patients with ATTR-CM had a shorter survival than controls (P<0.001 for both end points). Patients with ATTR-CM experiencing an early improvement in LV ejection fraction had a longer survival (log-rank, 4.3; P=0.038).
CONCLUSIONS: Following CRT implantation, patients with ATTR-CM show QRS narrowing and improvement in LV ejection fraction, not different from patients without amyloid cardiomyopathy. Early favorable LV remodeling seems to be associated with a lower risk of all-cause death.