PMID- 36128643 OWN - NLM STAT- MEDLINE DCOM- 20221223 LR - 20230118 IS - 2055-5822 (Electronic) IS - 2055-5822 (Linking) VI - 9 IP - 6 DP - 2022 Dec TI - An echo score raises the suspicion of cardiac amyloidosis in Chinese with heart failure with preserved ejection fraction. PG - 4280-4290 LID - 10.1002/ehf2.14164 [doi] AB - AIMS: Transthyretin 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. METHODS: Consecutive 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. RESULTS: Six 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. CONCLUSIONS: The 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. CI - (c) 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. FAU - Yang, Hong AU - Yang H AD - Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China. FAU - Li, Rui AU - Li R AD - Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China. FAU - Ma, Fei AU - Ma F AD - Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China. FAU - Wei, Ye AU - Wei Y AD - Department of Gynecologic Oncology, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China. FAU - Liu, Yujian AU - Liu Y AD - Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China. FAU - Sun, Yang AU - Sun Y AD - Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China. FAU - He, Xingwei AU - He X AD - Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China. FAU - Zeng, Hesong AU - Zeng H AD - Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China. FAU - Yan, Jiangtao AU - Yan J AD - Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China. FAU - Wang, Dao Wen AU - Wang DW AD - Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China. FAU - Wang, Hong AU - Wang H AUID- ORCID: 0000-0002-2028-4798 AD - Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China. LA - eng PT - Journal Article DEP - 20220920 PL - England TA - ESC Heart Fail JT - ESC heart failure JID - 101669191 SB - IM MH - Humans MH - Male MH - Female MH - *Heart Failure/diagnosis/epidemiology MH - Stroke Volume MH - East Asian People MH - *Amyloidosis MH - Echocardiography PMC - PMC9773758 OTO - NOTNLM OT - 99mTc-pyrophosphate scintigraphy OT - Heart failure with preserved ejection fraction OT - Multi-parametric echocardiography score OT - Transthyretin amyloid cardiomyopathy COIS- None declared. EDAT- 2022/09/22 06:00 MHDA- 2022/12/24 06:00 PMCR- 2022/09/20 CRDT- 2022/09/21 02:42 PHST- 2022/08/16 00:00 [revised] PHST- 2022/05/17 00:00 [received] PHST- 2022/09/10 00:00 [accepted] PHST- 2022/09/22 06:00 [pubmed] PHST- 2022/12/24 06:00 [medline] PHST- 2022/09/21 02:42 [entrez] PHST- 2022/09/20 00:00 [pmc-release] AID - EHF214164 [pii] AID - 10.1002/ehf2.14164 [doi] PST - ppublish SO - ESC Heart Fail. 2022 Dec;9(6):4280-4290. doi: 10.1002/ehf2.14164. Epub 2022 Sep 20.