title: Baseline Characteristics Predict the Presence of Amyloid on Endomyocardial Biopsy.
abstract: BACKGROUND
  Recent studies have suggested a high prevalence of cardiac amyloidosis (CAm) in heart failure (HF) patients. CAm might be underdiagnosed owing to low clinical suspicion.
  
  
  RESULTS
  We performed retrospective analysis of 259 patients with HF and ejection fraction (EF) ≥50% referred for endomyocardial biopsy. Seventy-three (28%) had CAm. Multivariable independent predictors of CAm were identified. Over a mean follow-up of 2.6 ± 3.3 years, CAm patients had worse survival than those without (1.5 y vs 6.3 y; log rank P < .0001).
  
  
  CONCLUSIONS
  Clinicians should be suspicious of CAm in patients with EF 50%-75%, >50 years of age, BMI <30 kg/m2, peripheral neuropathy, Sokolow-Lyon index ≤15 mm, and septal wall thickness ≥1.4 cm.
authors.affiliation: Advanced Heart Failure, Department of Cardiovascular Medicine, University of Maryland Medical Center, Baltimore, Maryland; Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Van-Khue
authors.initials: VK
authors.lastname: Ton
authors.affiliation: Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Aditya
authors.initials: A
authors.lastname: Bhonsale
authors.affiliation: Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Nisha A
authors.initials: NA
authors.lastname: Gilotra
authors.affiliation: Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Marc K
authors.initials: MK
authors.lastname: Halushka
authors.affiliation: Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Charles
authors.initials: C
authors.lastname: Steenbergen
authors.affiliation: Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Johana
authors.initials: J
authors.lastname: Almansa
authors.affiliation: Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Emily
authors.initials: E
authors.lastname: Brown
authors.affiliation: Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Tedford
authors.affiliation: Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Ilan
authors.initials: I
authors.lastname: Wittstein
authors.affiliation: Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Kavita
authors.initials: K
authors.lastname: Sharma
authors.affiliation: Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Stuart D
authors.initials: SD
authors.lastname: Russell
authors.affiliation: Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland. Electronic address: djudge@jhmi.edu.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Judge
mesh_terms: D000368:Aged; D000682:Amyloid / Q000032:analysis / Q000378:metabolism; D000686:Amyloidosis / Q000175:diagnosis* / Q000473:pathology; D001706:Biopsy / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D004699:Endocardium / Q000378:metabolism / Q000473:pathology; D004719:Endomyocardial Fibrosis / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006333:Heart Failure / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008396:Maryland; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D013223:Statistics as Topic; D013318:Stroke Volume
chemical_list: D000682:Amyloid
keywords: Cardiac amyloid; heart failure; predictors