PMID- 26234222
OWN - NLM
STAT- MEDLINE
DCOM- 20160301
LR  - 20190221
IS  - 1349-7235 (Electronic)
IS  - 0918-2918 (Linking)
VI  - 54
IP  - 15
DP  - 2015
TI  - Pericardial Effusion and Multiple Organ Involvement Are Independent Predictors of 
      Mortality in Patients with Systemic Light Chain Amyloidosis.
PG  - 1833-40
LID - 10.2169/internalmedicine.54.3500 [doi]
AB  - OBJECTIVE: Left ventricular (LV) functions assessed by echocardiography and 
      cardiac biomarkers are strong predictors of mortality in patients with systemic 
      light chain (AL) amyloidosis. However, most previous studies have been conducted 
      in Western countries, and the predictors of mortality in Asian patients with AL 
      amyloidosis have not been characterized. To address this issue, we aimed to 
      determine the predictors of mortality in Asian patients with biopsy-confirmed AL 
      amyloidosis. METHODS: We retrospectively enrolled 31 patients (59+/-11 years, 55% 
      men) in whom AL amyloidosis was confirmed by biopsies from cardiac or non-cardiac 
      tissues. Of these patients, 15 (48%) met the international echocardiographic 
      criteria for cardiac amyloidosis (mean LV wall thickness >12 mm without other 
      causes of LV hypertrophy). RESULTS: During a mean follow-up period of 21+/-20 
      months, 15 patients died. Non-survivors had a higher number of involved organs, 
      lower e', and higher rates of E/e' >15, pericardial effusion (PE), low voltage on 
      an electrocardiogram and a New York Heart Association (NYHA) functional class >/= 
      III, compared with survivors. In multivariate analysis, a NYHA functional class >/= 
      III (p=0.024) and cardiac involvement (p=0.032) were independent predictors of PE 
      in patients with AL amyloidosis. Multivariate Cox proportional hazard analysis 
      indicated that PE (hazard ratio: 21.9, p=0.025) and the number of involved organs 
      (hazard ratio: 2.8, p=0.015), but not LV diastolic parameters of tissue Doppler 
      echocardiography, independently predict mortality in patients with AL 
      amyloidosis. CONCLUSION: PE and multiple organ involvement, compared with e' and 
      E/e', are stronger predictors of mortality in patients with AL amyloidosis. The 
      advanced disease stage of AL amyloidosis might underlie the strong association 
      between PE and a poor outcome.
FAU - Yuda, Satoshi
AU  - Yuda S
AD  - Department of Clinical Laboratory Medicine, Sapporo Medical University School of 
      Medicine, Japan.
FAU - Hayashi, Toshiaki
AU  - Hayashi T
FAU - Yasui, Kenji
AU  - Yasui K
FAU - Muranaka, Atsuko
AU  - Muranaka A
FAU - Ohnishi, Hirofumi
AU  - Ohnishi H
FAU - Hashimoto, Akiyoshi
AU  - Hashimoto A
FAU - Ishida, Tadao
AU  - Ishida T
FAU - Tsuchihashi, Kazufumi
AU  - Tsuchihashi K
FAU - Shinomura, Yasuhisa
AU  - Shinomura Y
FAU - Watanabe, Naoki
AU  - Watanabe N
FAU - Miura, Tetsuji
AU  - Miura T
LA  - eng
PT  - Journal Article
DEP - 20150801
PL  - Japan
TA  - Intern Med
JT  - Internal medicine (Tokyo, Japan)
JID - 9204241
RN  - 0 (Immunoglobulin Light Chains)
SB  - IM
MH  - Aged
MH  - Amyloidosis/diagnostic imaging/*mortality
MH  - *Echocardiography, Doppler
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hypertrophy, Left Ventricular/diagnostic imaging/*mortality/physiopathology
MH  - *Immunoglobulin Light Chains
MH  - Immunoglobulin Light-chain Amyloidosis
MH  - Male
MH  - Middle Aged
MH  - Pericardial Effusion/diagnostic imaging/*mortality/physiopathology
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Ventricular Function, Left
EDAT- 2015/08/04 06:00
MHDA- 2016/03/02 06:00
CRDT- 2015/08/04 06:00
PHST- 2015/08/04 06:00 [entrez]
PHST- 2015/08/04 06:00 [pubmed]
PHST- 2016/03/02 06:00 [medline]
AID - 10.2169/internalmedicine.54.3500 [doi]
PST - ppublish
SO  - Intern Med. 2015;54(15):1833-40. doi: 10.2169/internalmedicine.54.3500. Epub 2015 
      Aug 1.