دورية أكاديمية

Deep phenotyping of p.( V142I)‐associated variant transthyretin amyloid cardiomyopathy: Distinct from wild‐type transthyretin amyloidosis?

التفاصيل البيبلوغرافية
العنوان: Deep phenotyping of p.( V142I)‐associated variant transthyretin amyloid cardiomyopathy: Distinct from wild‐type transthyretin amyloidosis?
المؤلفون: Razvi, Yousuf, Ioannou, Adam, Patel, Rishi K., Chacko, Liza, Karia, Nina, Riefolo, Mattia, Porcari, Aldostefano, Rauf, Muhammad Umaid, Starr, Neasa, Ganesananthan, Sashiananthan, Blakeney, Iona, Kaza, Nandita, Filisetti, Stefano, Bolhuis, Roos Eline, Rowczenio, Dorota, Gilbertson, Janet, Hutt, David, Mahmood, Shameem, Lachmann, Helen J., Wechalekar, Ashutosh D., Kotecha, Tushar, Knight, Daniel S., Coghlan, John G., Petrie, Aviva, Whelan, Carol J., Venneri, Lucia, Martinez‐Naharro, Ana, Hawkins, Phillip, Fontana, Marianna, Gillmore, Julian D.
المساهمون: British Heart Foundation
المصدر: European Journal of Heart Failure ; volume 26, issue 2, page 383-393 ; ISSN 1388-9842 1879-0844
بيانات النشر: Wiley
سنة النشر: 2024
المجموعة: Wiley Online Library (Open Access Articles via Crossref)
الوصف: Aims Transthyretin amyloid cardiomyopathy (ATTR‐CM) is an increasingly recognized cause of heart failure. A total of 3–4% of individuals of African descent carry a TTR gene mutation encoding the p.(V142I) variant, a powerful risk factor for development of variant ATTR‐CM (ATTRv‐CM); this equates to 1.6 million carriers in the United States. We undertook deep phenotyping of p.(V142I)‐ATTRv‐CM and comparison with wild‐type ATTR‐CM (ATTRwt‐CM). Methods and results A retrospective study of 413 patients with p.(V142I) ATTRv‐CM who attended the UK National Amyloidosis Centre (NAC) was conducted. Patients underwent evaluation at time of diagnosis, including clinical, echocardiography, and biomarker analysis; a subgroup had cardiac magnetic resonance (CMR) imaging. A total of 413 patients with ATTRwt‐CM, matched for independent predictors of prognosis (age, NAC Stage, decade of first presentation), were used as a comparator group. At time of diagnosis, patients with ATTRv‐CM had significant functional impairment by New York Heart Association classification (NHYA class ≥ III; 38%) and 6‐min walk test distance (median 276 m). Median 5‐year survival in ATTRv‐CM patients was 31 versus 59 months in matched patients with ATTRwt‐CM ( p < 0.001). Patients with ATTRv‐CM had significant impairment of functional parameters by echocardiography including biventricular impairment, high burden of regurgitant valvular disease and low cardiac output. Multivariable analysis revealed the prognostic importance of right ventricular dysfunction. CMR and histological analysis revealed myocyte atrophy and widespread myocardial infiltration in ATTRv‐CM. Conclusion p.(V142I)‐ATTRv‐CM has an aggressive phenotype characterized by myocyte loss and widespread myocardial infiltration which may account for frequent biventricular failure and poor prognosis in this ATTR‐CM genotypic subgroup.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1002/ejhf.3088
الإتاحة: https://doi.org/10.1002/ejhf.3088Test
حقوق: http://creativecommons.org/licenses/by-nc-nd/4.0Test/
رقم الانضمام: edsbas.D5F51C07
قاعدة البيانات: BASE