Prognostic implications of left ventricular myocardial work indices in cardiac amyloidosis

• Published in: European heart journal cardiovascular imaging 2021-05, Vol.22 (6), p.695-704
• Main Authors: Clemmensen, Tor Skibsted, Eiskjær, Hans, Ladefoged, Bertil, Mikkelsen, Fabian, Sørensen, Jens, Granstam, Sven-Olof, Rosengren, Sara, Flachskampf, Frank A, Poulsen, Steen Hvitfeldt
• Format: Article
• Language: English
• Subjects: cardiac amyloidosis; myocardial work; outcome prediction; speckle tracking echocardiography; strain
• ISSN: 2047-2404; 2047-2412; 2047-2412
• DOI: 10.1093/ehjci/jeaa097

Abstract Aims Left ventricular (LV) myocardial work index (LVMWI) derived from pressure–strain analysis resembles a novel non-invasive method for LV function evaluation. LV global longitudinal strain (LVGLS) has proven beneficial for risk stratification in cardiac amyloidosis (CA) patients. This study aimed to evaluate the potential additive value of LVMWI for outcome prediction in CA patients. Methods and results We enrolled 100 CA patients in the period 2014–19 from Aarhus University Hospital, Denmark and Uppsala University Hospital, Sweden. All patients underwent comprehensive echocardiographic evaluation and were prospectively followed until censuring date on 31 March 2019 or death. During follow-up, we registered major adverse cardiac events (MACE) comprising heart failure requiring hospitalization and all-cause mortality. The median follow-up was 490 (228–895) days. During follow-up, a total of 42% of patients experienced MACE and 29% died. Patients with LVMWI 1043 mmHg% [hazard ratio (HR) 2.3, 95% confidence interval (CI) 1.2–4.3; P = 0.01]. Furthermore, patients with LVMWI 1039 mmHg% (HR 2.6, 95% CI 1.2–5.5; P