Evidence map›Paper›PMID 39090841›Full record

ArticleESC heart failure2024

Importance of fourth heart sound and preserved left atrial function in wild-type transthyretin amyloidosis.

Yuri Ochi, Naohito Yamasaki, Toru Kubo, Yuichi Baba, Kazuya Miyagawa, Tatsuya Noguchi, Takayoshi Hirota, Tomoyuki Hamada, Hiroaki Kitaoka

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Yuri OchiDepartment of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Kochi, Japan.ORCID 0000-0002-3307-8555
Naohito YamasakiDepartment of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Kochi, Japan.
Toru KuboDepartment of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Kochi, Japan.
Yuichi BabaDepartment of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Kochi, Japan.
Kazuya MiyagawaDepartment of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Kochi, Japan.
Tatsuya NoguchiDepartment of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Kochi, Japan.
Takayoshi HirotaDepartment of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Kochi, Japan.
Tomoyuki HamadaDepartment of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Kochi, Japan.
Hiroaki KitaokaDepartment of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Kochi, Japan.

Funding

Japan Society for the Promotion of Science 18k08078
6 · The paper itself

Abstract

aimsA fourth heart sound (S4) was reported to be almost never present in patients with amyloid light-chain cardiomyopathy. There have been no reports on S4 in patients with wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM). This study aimed to clarify the clinical implications of S4 in patients with ATTRwt-CM. METHODS AND

resultsSeventy-six patients with ATTRwt-CM (mean age: 80.4 ± 5.4 years, 68 males) who had undergone phonocardiography (PCG) were retrospectively assessed. We measured S4 amplitude on digitally recorded PCG. S4 was considered to be present when its amplitude was 1.0 mm or greater on the PCG. Distinct S4 was defined as S4 with an amplitude of 2.0 mm or greater, which is usually recognizable by auscultation. According to the rhythm and presence or absence of S4, the patients were divided into three groups, namely, sinus rhythm (SR) with S4, SR without S4, and non-SR. Non-SR consisted of atrial fibrillation, atrial flutter, and atrial tachycardia. Thirty-six patients were in SR and the remaining 40 patients were in non-SR. In the 36 patients in SR, S4 was shown by PCG to be present in 17 patients (47%), and distinct S4 was recognized in 7 patients (19%) by auscultation. In patients who were in SR, those with S4 had higher systolic blood pressure (124 ± 15 vs. 99 ± 8 mmHg, P < 0.001), lower level of plasma B-type natriuretic peptide (308 [interquartile range (IQR): 165, 354] vs. 508 [389, 765] pg/mL, P = 0.034) and lower level of high-sensitivity cardiac troponin T (0.068 [0.046, 0.089] vs. 0.109 [0.063, 0.148] ng/mL, P = 0.042) than those without S4. There was no significant difference in left atrium (LA) volume index or LA reservoir strain between patients with S4 and without S4. Patients with S4 had more preserved LA systolic function than those without S4 (peak atrial filling velocity: 53 ± 25 vs. 34 ± 9 cm/s, P = 0.033; LA contractile strain: 4.1 ± 2.1 vs. 1.6 ± 2.0%, P = 0.012). Patients in SR without S4 had worse short-term prognosis compared with the other two groups (generalized Wilcoxon test, P = 0.033).

conclusionsS4 was present in 47% of the patients in SR with ATTRwt-CM. Patients in SR without S4 had more impaired LA systolic function than those in SR with S4. The absence of S4 portends a poor short-term prognosis in patients with ATTRwt-CM.

Indexed as

Amyloid Neuropathies, FamilialAtrial Function, LeftHeart AtriaHeart SoundsAgedAged, 80 and overCardiomyopathiesEchocardiographyFemaleFollow-Up StudiesHumansMalePhonocardiographyRetrospective StudiesATTRwt‐CMFourth heart soundLA functionPhonocardiographyWild‐type transthyretin amyloidosis

Identifiers

PMID39090841
PMCPMC11631332

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.