[An analysis of factors affecting the prognosis of patients with cardiac amyloidosis].
OBJECTIVE
To analyze the clinical characteristics, diagnosis, treatment and outcome of patients with cardiac amyloidosis (CA).


METHODS
Clinical data from 18 patients diagnosed as CA by endomyocardial biopsy (EMB) from 1995 to 2005 were retrospectively analyzed.


RESULTS
Among the 18 patients with CA, all patients had reduced diastolic dysfunction; 12 had mitral valve early diastolic blood flow peak velocity/late diastolic blood flow peak velocity (E/A) > 2.0 and ventricular diastolic early filling deceleration time (DT) < 150 ms; 12 had left ventricular ejection fraction (LVEF) < 50%; and 13 had New York Heart Association (NYHA) classification III or IV. The 1-year, 3-year and 5-year survival rates of 18 patients with CA were 67%, 44% and 17%, respectively. Kaplan-Meier analysis showed, NYHA functional class > II, E/A > 2.0 and DT < 150 ms were associated with increased mortality (log-rank statistic P = 0.026 and 0.001, respectively). CA patients with chemotherapy before heart failure were associated with decreased mortality and extend survival.


CONCLUSIONS
The mortality rate goes up and survival rate gradually descends as prolonged onset time. NYHA functional class >IIand E/A > 2.0 (DT< 150 ms) are associated with mortality.
Department of Cardiology, General Hospital of PLA, Beijing 100853, China.
Yan
Y
Zhang
Yi-Hong
YH
Ren
Geng
G
Qian
Chao-Fei
CF
Zhou
Qing-Kao
QK
Zhang
Peng-Cheng
PC
Zhao
Guo-Shu
GS
Liu
D000368:Aged; D000686:Amyloidosis / Q000401:mortality / Q000473:pathology*; D001706:Biopsy; D006328:Cardiac Catheterization; D009202:Cardiomyopathies; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016277:Ventricular Function, Left