ArticleESC heart failure2022
An echo score raises the suspicion of cardiac amyloidosis in Chinese with heart failure with preserved ejection fraction.
Article in ESC heart failure, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 9 citations in OpenAlex.
- A simple nomogram to help guide the diagnosis of cardiac amyloidosis in patients with heart failure with preserved ejection fraction.Quantitative imaging in medicine and surgery · 2026Article
- Development and validation of an echocardiographic nomogram for identifying cardiac amyloidosis in patients with left ventricular hypertrophy.BMC cardiovascular disorders · 2025Article
- Advancing diagnostics and therapy in transthyretin amyloid cardiomyopathy.ESC heart failure · 2025Article
- Cardiac amyloidosis: A diagnostic challenge.Radiology case reports · 2024Article
- Transthyretin amyloidosis prevalence and characteristics in Korean patients with heart failure with preserved or mildly reduced ejection fractions.Scientific reports · 2024Article
- Liver stiffness as a prognostic parameter and tool for risk stratification in advanced cardiac transthyretin amyloidosis.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Article
- An echo score raises the suspicion of cardiac amyloidosis in Chinese with heart failure with preserved ejection fraction.ESC heart failure · 2022Article
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Authors and funding
11 authors at 1 institution in 1 country.
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Abstract
aimsTransthyretin cardiac amyloidosis (ATTR-CA) has been realized as an important cause of heart failure with preserved ejection fraction (HFpEF). We aim to provide insights into its prevalence in Chinese HFpEF patients, which is not known to date, using increased wall thickness (IWT) score by echocardiography.
methodsConsecutive patients with HFpEF (EF ≥ 40%) and IWT (≥12 mm) were prospectively screened. Echocardiography was performed, and the IWT score incorporated relative wall thickness, E/e' ratio, longitudinal strains, and tricuspid annular plane systolic excursion, and septal apical-to-base ratio was calculated. ATTR-CA was defined as score ≥8 in the absence of serum and urine free light chain.
resultsSix hundred twenty-four HFpEF patients from January 2019 to December 2021 were enrolled, of which 65.2% were males and the median (interquartile range [IQR]) age was 66 (IQR 57, 73) years. Thirty-three patients (5.3%, 95% CI 3.5-7.0%) were with score ≥8, and 33.3% were females. They were younger (58 vs. 69 years, P < 0.001), had higher NT-proBNP (6525.0 vs. 1741.5 pg/mL, P < 0.001) and troponin I (105.2 vs. 27.7 pg/mL, P = 0.001) level, and lower LVEF (47% vs. 57%, P < 0.001) compared with the patients with score <5. In the internal cohort (82 patients) who had undergone scintigraphy, the IWT score ≥8 was shown to have a sensitivity of 85.7% (95% CI 56.2-97.5%) and a specificity of 92.6% (95% CI 83.0-97.3%) for diagnosing CA, and the IWT score <5 had great accuracy in excluding CA with the negative predictive value of 100%, supporting the clinical usefulness of the IWT score to guide further dedicated testing for ATTR-CA.
conclusionsThe IWT score by echocardiography was an excellent tool for screening ATTR-CA in HFpEF. In Chinese HFpEF patients associated with a hypertrophic phenotype, the proportion of highly suspected ATTR-CA as detected by IWT score ≥8 was 5.3%, lower than the reported prevalence of ATTR-CA in non-Asian patients with the disease.
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