Department of Nephrology, Kidney Hospital, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Office of Health Care for Cadres, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Clin Cardiol. 2020 Oct;43(10):1160-1166. doi: 10.1002/clc.23426. Epub 2020 Jul 28.
Cardiac involvement frequently occurs in patients with renal light chain (AL) amyloidosis, which predisposes these patients to heart failure, arrhythmia, or infarction with poor prognosis.
Twelve-lead electrocardiogram (ECG) parameters may be associated with prognosis in renal AL amyloidosis.
A retrospective single-center cohort study was performed. Biopsy-proven renal AL amyloidosis patients from January 2014 to December 2018 at the First Affiliated Hospital of Xi'an Jiaotong University were enrolled. The baseline demographic information, laboratory tests, 12-lead ECG parameters at the time of diagnosis were obtained from medical records. The endpoint was defined as the time to all-cause death from baseline for all deceased patients and time to censor date (June 2019) for all other patients. Univariate and multivariate Cox proportional hazard models were conducted to identify the relationship between ECG parameters and all-cause mortality.
A total of 69 patients with a mean age of 61.5 ± 11.4 years were enrolled in this study. The median PR interval and QTc interval were 160 (140, 186) and 417 ± 42 ms. The mean follow-up duration was 15.9 ± 13.8 months. Multivariate Cox regression analysis showed that regardless of adjustment for age, gender and serum creatinine, PR interval (HR 1.022, 95% CI: 1.007-1.038, P = .005), and QTc interval (HR 1.012, 95% CI: 1.004-1.021, P = .004) were independently associated with all-cause mortality.
PR interval and QTc interval were independently associated with all-cause mortality in renal AL amyloidosis patients. ECG parameters may provide prognostic potential of renal AL amyloidosis patients and promote the management of patients with renal AL amyloidosis.
心脏受累在肾轻链（AL）淀粉样变患者中很常见，这使这些患者易发生心力衰竭、心律失常或梗死，预后不良。
十二导联心电图（ECG）参数可能与肾 AL 淀粉样变的预后相关。
进行了一项回顾性单中心队列研究。纳入了 2014 年 1 月至 2018 年 12 月西安交通大学第一附属医院经活检证实的肾 AL 淀粉样变患者。从病历中获取了基线人口统计学信息、实验室检查和诊断时的 12 导联 ECG 参数。终点定义为所有死亡患者从基线开始的全因死亡时间和所有其他患者的截止日期（2019 年 6 月）。采用单变量和多变量 Cox 比例风险模型来确定 ECG 参数与全因死亡率之间的关系。
本研究共纳入 69 例患者，平均年龄 61.5±11.4 岁。PR 间期和 QTc 间期的中位数分别为 160（140，186）和 417±42ms。平均随访时间为 15.9±13.8 个月。多变量 Cox 回归分析显示，无论是否校正年龄、性别和血清肌酐，PR 间期（HR 1.022，95%CI：1.007-1.038，P=0.005）和 QTc 间期（HR 1.012，95%CI：1.004-1.021，P=0.004）均与全因死亡率独立相关。
PR 间期和 QTc 间期与肾 AL 淀粉样变患者的全因死亡率独立相关。心电图参数可能为肾 AL 淀粉样变患者提供预后潜力，并促进肾 AL 淀粉样变患者的管理。
