Department of Cardiology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.
Dis Markers. 2023 May 16;2023:3070017. doi: 10.1155/2023/3070017. eCollection 2023.
To identify the survival and prognostic factors for cardiac amyloidosis (CA) in Chinese patients.
This was a prospective cohort study of 72 patients diagnosed with CA and admitted to the PLA General Hospital between November 2017 and April 2021. Demographic, clinical, laboratory, electrocardiographic, conventional ultrasound, endocardial LS during LV systole (LV ENDO LSsys), and myocardial strain data were recorded. Survival was assessed. All-cause mortality was the endpoint. Follow-up was censored on September 30, 2021.
The mean follow-up was 17.1 ± 12.9 months. Among the 72 patients, 39 died, 23 survived, and 10 were lost to follow-up. Mean survival for all patients was 24.7 ± 2.2 months. Mean survival was 32.7 ± 2.4 months among patients with NYHA class II, 26.6 ± 3.4 months for NYHA class III, and 5.8 ± 1.1 months for NYHA class IV. The multivariate Cox proportional hazard regression model showed that NYHA class (HR = 3.42, 95% CI: 1.36-8.65, = 0.002), log-proBNP level (HR = 1.40, 95% CI: 1.17-5.83, = 0.03), and ENDO LSsys of the LV basal level (HR = 1.25, 95% CI: 1.05-1.95, = 0.004) were independent prognostic factors for CA.
NYHA class, proBNP level, and ENDO LSsys of the LV basal level were independently associated with the survival of patients with CA.
确定中国患者心脏淀粉样变性（CA）的生存和预后因素。
这是一项前瞻性队列研究，纳入了 2017 年 11 月至 2021 年 4 月期间在中国人民解放军总医院就诊的 72 例 CA 患者。记录了人口统计学、临床、实验室、心电图、常规超声、左心室收缩期心内膜 LS（LV ENDO LSsys）和心肌应变数据。评估了生存情况。全因死亡率为终点。随访截止日期为 2021 年 9 月 30 日。
平均随访时间为 17.1±12.9 个月。72 例患者中，39 例死亡，23 例存活，10 例失访。所有患者的平均生存时间为 24.7±2.2 个月。NYHA 心功能分级 II 级患者的平均生存时间为 32.7±2.4 个月，NYHA 心功能分级 III 级为 26.6±3.4 个月，NYHA 心功能分级 IV 级为 5.8±1.1 个月。多变量 Cox 比例风险回归模型显示，NYHA 心功能分级（HR=3.42，95%CI：1.36-8.65，P=0.002）、log-proBNP 水平（HR=1.40，95%CI：1.17-5.83，P=0.03）和 LV 基底节段的 ENDO LSsys（HR=1.25，95%CI：1.05-1.95，P=0.004）是 CA 的独立预后因素。
NYHA 心功能分级、proBNP 水平和 LV 基底节段的 ENDO LSsys 与 CA 患者的生存独立相关。
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