1. Electromechanical dissociation of left atrium in patients with Cardiac Amyloidosis by Magnetic Resonance: Prognostic and clinical correlates
- Author
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Giovanni Donato Aquaro, Sofia Morini, Chrysanthos Grigoratos, Giulia Taborchi, Gianluca Di Bella, Raffaele Martone, Elisa Vignini, Michele Emdin, Iacopo Olivotto, Federico Perfetto, and Francesco Cappelli
- Subjects
Cardiac amyloidosis ,Cardiac magnetic resonance ,Prognosis ,Left atrial function ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objectives: Left atrial (LA) function is an important marker of hemodynamic status in cardiac amyloidosis (CA), and its characterization may provide relevant prognostic information. We sought to assess the prevalence and prognostic impact of LA dysfunction by cardiac magnetic resonance (CMR) in patients with CA. Methods: We performed CMR in 80 consecutive patients with CA, including 38 with AL (47%) and 42 with ATTR (53%). LA function was assessed by acquiring short axis cine steady-state free precession (SSFP) covering the entire chamber. The atrial emptying fraction (AEF) was calculated as the ratio between the difference of LA maximal and minimal volume to LA maximal volume, expressed as percentage. Severe atrial dysfunction was defined as AEF ≤ 14%. Results: Mean AEF was 18% (13–35%). Overall, AEF ≤ 14% was present in 19 patients (24%), including 21% of those in sinus rhythm (SR) with no history of atrial fibrillation (AF). After a median of 3 years (IQR 2–4), 36 patients (44%) died of cardiac causes. Patients with AEF ≤ 14% showed increased cardiac mortality, with an independent OR of 4.2 (95 IC 2.1–8.2, P
- Published
- 2020
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