PMID- 26685729
OWN - NLM
STAT- MEDLINE
DCOM- 20170623
LR  - 20181202
IS  - 1876-4738 (Electronic)
IS  - 0914-5087 (Linking)
VI  - 68
IP  - 5
DP  - 2016 Nov
TI  - Clinical correlates and prognostic values of pseudoinfarction in cardiac 
      light-chain amyloidosis.
PG  - 426-430
LID - S0914-5087(15)00370-6 [pii]
LID - 10.1016/j.jjcc.2015.11.004 [doi]
AB  - BACKGROUND: Pseudoinfarction is one of the most common electrocardiographic 
      characteristics in cardiac light-chain (AL) amyloidosis. The aim of the present 
      study was to analyze the prognostic significance of pseudoinfarction and define 
      the relation between pseudoinfarction and clinical parameters in cardiac AL 
      amyloidosis. METHODS: A total 110 consecutive patients who presented with a 
      diagnosis of cardiac AL amyloidosis and without a positive history of coronary 
      disease between 2010 and 2014 were enrolled. Patients were divided into two 
      groups according to the presence (n=40) or absence (n=70) of pseudoinfarction on 
      electrocardiography (ECG). Clinical parameters including laboratory tests, 
      echocardiography, and follow-up were collected and analyzed. RESULTS: Patients 
      with pseudoinfarction had higher N-terminal pro-brain natriuretic peptide levels 
      (9131pg/ml vs 4644pg/ml, p=0.02) and a worse New York Heart Association (NYHA) 
      function (p<0.001). The pseudoinfarction group also had a larger left atrium size 
      (44mm vs 41mm, p=0.03), a thicker ventricular wall (septum 14mm vs 13mm, p=0.005 
      and posterior wall 14mm vs 13mm, p=0.01), a lower left ventricular ejection 
      fraction (50% vs 58%, p=0.013), and higher early-to-atrial transmitral flow 
      velocity ratio (p=0.001). Also, the pseudoinfarction group was closely associated 
      with a lower voltage (70% vs 38.6%, p=0.002), poor precordial R wave progression 
      (78.4% vs 43.9%, p=0.001), lower Sokolow-Lyon index (13mm vs 9mm, p<0.001), and 
      lower voltage to mass ratio (0.521 vs 0.442, p=0.028) on the ECG. After a median 
      follow-up of 39 months, Kaplan-Meier survival analysis showed that lifetime was 
      significantly shorter in the pseudoinfarction group (median 4 months vs 17 
      months, p<0.001). By adopting the multivariate Cox proportional model, NYHA heart 
      failure III to IV and the presence of pseudoinfarction remained the only two 
      independent prognostic determinants with death hazard ratio of 3.16 and 1.9, 
      respectively. CONCLUSIONS: The presence of pseudoinfarction on the ECG has a 
      negative prognostic effect on AL patients with cardiac involvement.
CI  - Copyright (c) 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All 
      rights reserved.
FAU - Zhao, Lei
AU  - Zhao L
AD  - Department of Cardiology, Peking Union Medical College Hospital, Peking Union 
      Medical College and Chinese Academy of Medical Sciences, Beijing, China.
FAU - Li, Jian
AU  - Li J
AD  - Department of Hematology, Peking Union Medical College Hospital, Peking Union 
      Medical College and Chinese Academy of Medical Sciences, Beijing, China.
FAU - Tian, Zhuang
AU  - Tian Z
AD  - Department of Cardiology, Peking Union Medical College Hospital, Peking Union 
      Medical College and Chinese Academy of Medical Sciences, Beijing, China. 
      Electronic address: tianzhuangcn@163.com.
FAU - Fang, Quan
AU  - Fang Q
AD  - Department of Cardiology, Peking Union Medical College Hospital, Peking Union 
      Medical College and Chinese Academy of Medical Sciences, Beijing, China. 
      Electronic address: quanfangxjn2013@163.com.
LA  - eng
PT  - Journal Article
DEP - 20151210
PL  - Netherlands
TA  - J Cardiol
JT  - Journal of cardiology
JID - 8804703
RN  - 0 (N-terminal proatrial natriuretic peptide)
RN  - 0 (Protein Precursors)
RN  - 85637-73-6 (Atrial Natriuretic Factor)
SB  - IM
MH  - Amyloidosis/*mortality
MH  - Atrial Natriuretic Factor/blood
MH  - Blood Flow Velocity
MH  - Echocardiography
MH  - *Electrocardiography
MH  - Female
MH  - Heart Atria/diagnostic imaging
MH  - Heart Diseases/*mortality
MH  - Heart Failure/mortality
MH  - Heart Ventricles/diagnostic imaging
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Prognosis
MH  - Protein Precursors/blood
MH  - Stroke Volume
OTO - NOTNLM
OT  - Amyloidosis
OT  - Echocardiography
OT  - Electrocardiography
OT  - Prognosis
OT  - Pseudoinfarction
EDAT- 2016/10/19 06:00
MHDA- 2017/06/24 06:00
CRDT- 2015/12/22 06:00
PHST- 2015/07/13 00:00 [received]
PHST- 2015/10/26 00:00 [revised]
PHST- 2015/11/07 00:00 [accepted]
PHST- 2016/10/19 06:00 [pubmed]
PHST- 2017/06/24 06:00 [medline]
PHST- 2015/12/22 06:00 [entrez]
AID - S0914-5087(15)00370-6 [pii]
AID - 10.1016/j.jjcc.2015.11.004 [doi]
PST - ppublish
SO  - J Cardiol. 2016 Nov;68(5):426-430. doi: 10.1016/j.jjcc.2015.11.004. Epub 2015 Dec 
      10.