학술논문
Effect of tafamidis on left atrial function of patients with transthyretin amyloid cardiomyopathy.
Document Type
Academic Journal
Author
Uemura K; Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan.; Ichikawa Y; Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan.; Nagai S; Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan.; Nishihara Y; Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan.; Todo S; Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan.; Oota E; Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan.; Odajima S; Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan.; Takeuchi K; Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan.; Kintsu M; Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan.; Fukuda T; Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan.; Hisamatsu E; Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan.; Hirata KI; Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan.; Tanaka H; Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, 650-0017, Japan. tanakah@med.kobe-u.ac.jp.
Source
Publisher: Springer Verlag Country of Publication: Japan NLM ID: 8511258 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1615-2573 (Electronic) Linking ISSN: 09108327 NLM ISO Abbreviation: Heart Vessels Subsets: MEDLINE
Subject
Language
English
Abstract
Transthyretin amyloid cardiomyopathy (ATTR-CM) is characterized by the functional and structural effects of amyloid infiltration, predominantly within the ventricles, causing biventricular wall thickening. Amyloid infiltration can be observed in the left atrium in ATTR-CM patients, but the association of left atrial (LA) myocardial function with cardiovascular events and of changes in LA myocardial function with tafamidis administration have not yet been clarified. Our aim was, therefore, to use speckle-tracking strain for investigating LA myocardial function in patients with ATTR-CM treated with tafamidis. We studied 55 patients with biopsy-proven ATTR-CM who had been treated with tafamidis (age: 76 ± 2 years, male: 93%). For speckle-tracking analysis of LA myocardial function, the systolic LA strain (LA reservoir function) was defined for this study as LA myocardial function from the apical 4-chamber view. The primary endpoint was defined as a composite comprising cardiovascular death and/or heart failure hospitalization after tafamidis administration over a median follow-up period of 28 ± 4 months. Patients with baseline LA strain < 8.6% (median value) experienced significantly more cardiovascular events than those without (log-rank P = 0.002). Moreover, LA strain in 26 patients worsened after tafamidis administration, and multivariate logistic regression analysis showed age, global longitudinal strain and relative apical longitudinal strain index were identified as independent determinants of deterioration of LA strain after tafamidis administration. In conclusion, baseline LA reservoir function is closely associated with cardiovascular events after tafamidis administration, and could be an additional parameter for the management of patients with ATTR-CM.
(© 2024. Springer Nature Japan KK, part of Springer Nature.)
(© 2024. Springer Nature Japan KK, part of Springer Nature.)