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- Title
Left atrial reservoir strain as a novel predictor of new-onset atrial fibrillation in light-chain-type cardiac amyloidosis.
- Authors
Choi, You-Jung; Kim, Darae; Rhee, Tea-Min; Lee, Hyun-Jung; Park, Jun-Bean; Lee, Seung-Pyo; Chang, Sung-A; Kim, Yong-Jin; Jeon, Eun-Seok; Oh, Jae K; Choi, Jin-Oh; Kim, Hyung-Kwan
- Abstract
Aims To investigate whether left arterial reservoir strain (LASr) could predict new-onset atrial fibrillation (NOAF) in patients with light-chain-type cardiac amyloidosis (ALCA). Methods and results This study enrolled 427 patients with CA from two tertiary centres between 2005 and 2019. LASr was measured using a vendor-independent analysis programme. The primary outcome was NOAF. A total of 287 patients with ALCA were included [median age 63.0 (56.0–70.0) years, 53.3% male]. The median LASr was 13.9% (10.5–20.8%). During the median follow-up of 0.85 years, AF occurred in 34 patients (11.8%). In the receiver operating characteristics curve analysis, the optimal cut-off of LASr for predicting NOAF was 14.4%. Patients with LASr ≤14.4% had a higher risk of NOAF than those with LASr >14.4% (18.1% vs. 5.1%, P < 0.010). In the multivariate analysis adjusting for confounding factors, including left arterial volume index and left ventricular global longitudinal strain (LV-GLS), higher LASr (%) was independently associated with lower risk for NOAF [adjusted hazard ratio (aHR): 0.936, 95% confidence interval (95% CI): 0.879–0.997, P = 0.039]. Furthermore, LASr ≤14.4% was an independent predictor for NOAF (aHR: 3.370, 95% CI: 1.337–8.492, P = 0.010). This remained true after accounting for all-cause death as a competing risk. Compared with Model 1 (LV-GLS) and Model 2 (LV-GLS plus LAVI), Model 3, including LASr showed a better reclassification ability for predicting NOAF (net reclassification index = 0.735, P < 0.001 compared with Model 1; net reclassification index = 0.514, P = 0.003 compared with Model 2). Conclusion LASr was an independent predictor of NOAF in patients with ALCA.
- Subjects
ATRIAL fibrillation risk factors; CARDIAC amyloidosis; ECHOCARDIOGRAPHY; CONFIDENCE intervals; MULTIVARIATE analysis; LEFT ventricular dysfunction; RISK assessment; DESCRIPTIVE statistics; RESEARCH funding; PREDICTION models; RECEIVER operating characteristic curves; LEFT heart atrium; DISEASE complications
- Publication
European Heart Journal - Cardiovascular Imaging, 2023, Vol 24, Issue 6, p751
- ISSN
2047-2404
- Publication type
Article
- DOI
10.1093/ehjci/jeac269