PMID- 30010028
OWN - NLM
STAT- MEDLINE
DCOM- 20190403
LR  - 20200225
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Print)
IS  - 1071-9164 (Linking)
VI  - 24
IP  - 8
DP  - 2018 Aug
TI  - Myocardial Contraction Fraction by M-Mode Echocardiography Is Superior to 
      Ejection Fraction in Predicting Mortality in Transthyretin Amyloidosis.
PG  - 504-511
LID - S1071-9164(18)30258-6 [pii]
LID - 10.1016/j.cardfail.2018.07.001 [doi]
AB  - BACKGROUND: Transthyretin amyloidosis (ATTR) is often associated with cardiac 
      involvement manifesting as conduction disease as well as restrictive 
      cardiomyopathy causing heart failure and death. Myocardial contraction fraction 
      (MCF), the ratio of left ventricular stroke volume (SV) to myocardial volume 
      (MV), is a volumetric measure of myocardial shortening that is superior to 
      ejection fraction (EF) in predicting mortality in patients with primary amyloid 
      light chain cardiac amyloidosis. We hypothesized that MCF would be an independent 
      predictor of survival in TTR-CA. METHODS AND RESULTS: MCF was derived from 
      2-dimensional echocardiography-guided M-mode data for 530 subjects in the 
      Transthyretin Amyloidosis Outcomes Survey (THAOS) database: age 61 +/- 16years, 74% 
      male, 158 wild-type (ATTRwt) and 372 mutant (ATTRm), follow-up 1.5 +/- 1.7years. 
      Using multivariate Cox proportional hazard regression models, MCF <25% was highly 
      associated with survival (hazard ratio [HR] 8.5, 95% confidence interval [CI] 
      4.8-14.9,-P < .0001), which was stronger than the association of EF dichotomized 
      at 50% (HR 2.8, 95% CI 1.8-4.4; P < .0001). MCF <25% remained significantly 
      predictive of survival in a multivariate model that included systolic blood 
      pressure, estimated glomerular filtration rate <65 mL.min(-1).m(-2), New York 
      Heart Association (NYHA) functional class, and health status based on the 
      EuroQol-5D-3L questionnaire (area under the receiver operating characteristic 
      curve [AUC] = 0.83, 95% CI 0.78-0.89). CONCLUSIONS: MCF was superior to EF in 
      predicting mortality in patients with ATTR. A predictive model combining MCF with 
      systolic blood pressure, renal function, NYHA functional class, and health status 
      was strongly associated with survival in patients with ATTR. CLINICALTRIALS. GOV 
      IDENTIFIER: NCT00628745.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Rubin, Jonah
AU  - Rubin J
AD  - Department of Medicine, Columbia University Medical Center, New York, New York.
FAU - Steidley, D Eric
AU  - Steidley DE
AD  - Department of Cardiovascular Disease, Mayo Clinic, Phoenix, Arizona.
FAU - Carlsson, Martin
AU  - Carlsson M
AD  - Pfizer, New York, New York.
FAU - Ong, Moh-Lim
AU  - Ong ML
AD  - Pfizer, New York, New York.
FAU - Maurer, Mathew S
AU  - Maurer MS
AD  - Department of Medicine, Columbia University Medical Center, New York, New York. 
      Electronic address: msm10@cumc.columbia.edu.
LA  - eng
SI  - ClinicalTrials.gov/NCT00628745
GR  - K24 AG036778/AG/NIA NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20180817
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
RN  - Amyloidosis, Hereditary, Transthyretin-Related
SB  - IM
MH  - Amyloid Neuropathies, Familial/*complications/genetics/mortality
MH  - Echocardiography/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*diagnosis/etiology/physiopathology
MH  - Heart Ventricles/diagnostic imaging/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction/*physiology
MH  - Prognosis
MH  - ROC Curve
MH  - Retrospective Studies
MH  - Stroke Volume/*physiology
MH  - Survival Rate/trends
MH  - United States/epidemiology
PMC - PMC6372291
MID - NIHMS982528
OTO - NOTNLM
OT  - ATTR
OT  - MCF
OT  - Myocardial contraction fraction
OT  - ejection fraction
OT  - transthyretin amyloidosis
EDAT- 2018/07/17 06:00
MHDA- 2019/04/04 06:00
PMCR- 2019/08/17
CRDT- 2018/07/17 06:00
PHST- 2017/09/14 00:00 [received]
PHST- 2018/06/28 00:00 [revised]
PHST- 2018/07/03 00:00 [accepted]
PHST- 2018/07/17 06:00 [pubmed]
PHST- 2019/04/04 06:00 [medline]
PHST- 2018/07/17 06:00 [entrez]
PHST- 2019/08/17 00:00 [pmc-release]
AID - S1071-9164(18)30258-6 [pii]
AID - 10.1016/j.cardfail.2018.07.001 [doi]
PST - ppublish
SO  - J Card Fail. 2018 Aug;24(8):504-511. doi: 10.1016/j.cardfail.2018.07.001. Epub 
      2018 Aug 17.