a Cardiology Unit, Department of Experimental, Diagnostic and Specialty Medicine - DIMES, Alma Mater Studiorum , University of Bologna , Bologna , Italy .
Amyloid. 2015;22(3):147-55. doi: 10.3109/13506129.2015.1028616. Epub 2015 Jun 5.
Although atrial fibrillation (AF) is a known complication of amyloidotic cardiomyopathy (AC), a precise pathophysiological and prognostic characterization is not available. We therefore aimed to assess prevalence, incidence, risk factors and prognostic significance of AF in light-chain (AL), hereditary transthyretin-related (m-ATTR) and non-mutant transthyretin-related (wt-ATTR) AC.
Retrospective study of 262 patients with AC (123 AL, 94 m-ATTR, 45 wt-ATTR) from a single center.
AF prevalence was 15% (AL 9%, m-ATTR 11%, wt-ATTR 40%). During a median follow-up of 1.2 years 11 patients developed AF (2.1% person-years). Age, heart failure (HF), left ventricular (LV) ejection fraction, renal involvement, left atrial size and right atrial pressure were independently associated with AF. AF was associated with incident HF but not with increased mortality. All AF patients were prescribed warfarin and none suffered thromboembolic events.
In AC the prevalence of AF varies widely according to etiology with a mean value of 15% that reaches 40% in wt-ATTR amyloidosis. Age, HF, LV ejection fraction, left atrial size and right atrial pressure were the main independent risk factors, while wall thickness and etiology were not the main independent risk factors. AF does not seem to impact all-cause mortality but was strongly associated with prevalent and incident HF.
尽管心房颤动（AF）是淀粉样心肌病（AC）的已知并发症，但目前尚无明确的病理生理学和预后特征。因此，我们旨在评估轻链（AL）、遗传性转甲状腺素蛋白相关（m-ATTR）和非突变转甲状腺素蛋白相关（wt-ATTR）AC 中 AF 的患病率、发病率、危险因素和预后意义。
回顾性研究了来自单一中心的 262 例 AC 患者（123 例 AL、94 例 m-ATTR、45 例 wt-ATTR）。
AF 的患病率为 15%（AL 为 9%，m-ATTR 为 11%，wt-ATTR 为 40%）。在中位随访 1.2 年期间，有 11 例患者发生了 AF（2.1%人年）。年龄、心力衰竭（HF）、左心室（LV）射血分数、肾脏受累、左心房大小和右心房压力与 AF 独立相关。AF 与 HF 事件的发生有关，但与死亡率的增加无关。所有 AF 患者均接受了华法林治疗，且无一例发生血栓栓塞事件。
在 AC 中，AF 的患病率根据病因差异很大，平均值为 15%，在 wt-ATTR 淀粉样变性中达到 40%。年龄、HF、LV 射血分数、左心房大小和右心房压力是主要的独立危险因素，而壁厚度和病因不是主要的独立危险因素。AF 似乎不会影响全因死亡率，但与普遍存在和新发 HF 密切相关。
Zotero 插件