title: Value of tissue Doppler-derived Tei index and two-dimensional speckle tracking imaging derived longitudinal strain on predicting outcome of patients with light-chain cardiac amyloidosis.
abstract: Prognosis of patients with light-chain cardiac amyloidosis (AL-CA) is poor. Speckle tracking imaging (STI) derived longitudinal deformation parameters and Doppler-derived left ventricular (LV) Tei index are valuable predictors of outcome in patients with AL-CA. We estimated the prognostic utility of Tei index and deformation parameters in 58 comprehensively phenotyped patients with AL-CA after a median follow-up of 365 days (quartiles 121, 365 days). The primary end point was all-cause mortality. 19 (33%) patients died during follow-up. Tei index (0.89 ± 0.29 vs. 0.61 ± 0.16, p < 0.001) and E to global early diastolic strain rate ratio (E/GLSRdias) were higher while global longitudinal systolic strain (GLSsys) was lower in non-survivors than in survivors (all p < 0.05). Tei index, NYHA functional class, GLSsysand E/GLSRdiaswere independent predictors of all-cause mortality risk, and Tei index ≥0.9 (HR 7.01, 95% CI 2.43-20.21, p < 0.001) was the best predictor of poor outcome. Combining Tei index and GLSsysyielded the best results on predicting death within 1 year (100% with Tei index ≥0.9 and GLSsys≤13%) or survival (95% with Tei index ≤0.9 and GLSsys≥13%). We conclude that 1-year mortality risk in AL-CA patients can be reliably predicted using Tei index or deformation parameters, with combined analysis offering best performance.
authors.affiliation: Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany.|Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
authors.forename: Dan
authors.initials: D
authors.lastname: Liu
authors.affiliation: Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany.|Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Hu
authors.affiliation: Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany.|Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Herrmann
authors.affiliation: Department for Cardiovascular Diseases, University Hospital Center Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: Maja
authors.initials: M
authors.lastname: Cikes
authors.affiliation: Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany.|Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Ertl
authors.affiliation: Medical Clinic II, Katharinen-Hospital Unna, Unna, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Weidemann
authors.affiliation: Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany. Stoerk_S@ukw.de.|Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany. Stoerk_S@ukw.de.
authors.forename: Stefan
authors.initials: S
authors.lastname: Störk
authors.affiliation: Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany. nordbeck_p@ukw.de.|Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany. nordbeck_p@ukw.de.
authors.forename: Peter
authors.initials: P
authors.lastname: Nordbeck
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D000075363:Immunoglobulin Light-chain Amyloidosis / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013314:Stress, Mechanical; D013318:Stroke Volume; D013997:Time Factors; D016277:Ventricular Function, Left
keywords: Cardiomyopathy; Strain rate; Tei index; Tissue Doppler echocardiography