Estimating nuclear scanning capacity requirements for patients with suspected cardiac transthyretin amyloidosis

For the present analysis, we focused only on patients with HF who had at their initial visit (i) a diagnosis of HF, based on symptoms and signs together with a raised N-terminal pro-brain natriuretic peptide (NT-proBNP) (≥400 ng/L) 4; (ii) LVEF ≥45%, corresponding to mild or no evidence of LVSD, as...

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Published inESC Heart Failure Vol. 10; no. 2; pp. 1492 - 1496
Main Authors Leo, Vincenzo C., Kazmi, Syed, Brownrigg, Jack, Araghi, Marzieh, Sarna, Harpreet S., Pellicori, Pierpaolo, Cuthbert, Joe, Cleland, John G.F., Clark, Andrew L.
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Abstract For the present analysis, we focused only on patients with HF who had at their initial visit (i) a diagnosis of HF, based on symptoms and signs together with a raised N-terminal pro-brain natriuretic peptide (NT-proBNP) (≥400 ng/L) 4; (ii) LVEF ≥45%, corresponding to mild or no evidence of LVSD, as determined by echocardiography; and (iii) measurements of LVWT. HF, heart failure; LVEF, left ventricular ejection fraction; LVWT, left ventricular wall thickness; NT-proBNP, N-terminal pro-brain natriuretic peptide; SBP, systolic blood pressure. <14 mm) Age at referral (years) 78 (72, 83) 78 (72, 83) 0.54 77 (72, 82) 78 (72, 83) 0.03 Male (%) 56 45 <0.0001 59 49 0.004 BMI (kg/m2) 28 (25, 33) 27 (24, 31) 0.003 28 (25, 32) 28 (24, 32) 0.11 SBP (mmHg) 148 (130, 167) 142 (126, 163) 0.001 148 (130, 171) 145 (128, 163) 0.057 SBP < 140 mmHg (%) 38 45 0.004 39 42 0.34 DBP (mmHg) 79 (69, 89) 77 (68, 89) 0.17 79 (69, 90) 78 (68, 89) 0.59 HR (BPM) 71 (60, 84) 72 (62, 84) 0.26 69 (60, 81) 72 (61, 84) 0.89 NYHA class III/IV 32 31 0.85 29 32 0.54 6MWT (m) 288 (120, 375) 300 (135, 360) 0.88 300 (147, 375) 288 (120, 375) 0.41 ECG Heart rate (bpm) 71 (60, 84) 72 (62, 84) 0.26 69 (60, 81) 71 (61, 8) 0.08 PR interval (ms) 172 (154, 198) 168 (151, 194) 0.04 169 (154, 202) 170 (152, 196) 0.63 QRS duration (ms) 98 (88, 116) 92 (84, 108) <0.0001 100 (88, 119) 94 (84, 110) 0.0001 NT-proBNP (ng/L) 1386 (778, 2558) 1244 (776, 2256) 0.02 1497 (811, 2675) 1286 (773, 2325) 0.04 Co-morbidities AF (%) 44 48 0.13 41 47 0.08 IHD (%) 33 34 0.44 37 33 0.27 History of hypertension (%) 52 44 0.002 55 48 0.02 Diabetes (%) 27 22 0.04 32 24 0.005 COPD (%) 8 9 0.20 8 9 0.64 Treatment at referral Loop diuretics (%) 72 65 0.002 71 68 0.26 Thiazide diuretics (%) 8 8 0.93 7 8 0.63 ACEi/ARB (%) 63 61 0.44 61 63 0.68 Beta blockers (%) 56 61 0.03 51 60 0.007 MRA (%) 12 10 0.16 12 11 0.46 Echocardiography LVEF (%) 54 (48, 60) 55 (49, 60) 0.39 53 (47, 59) 55 (49, 61) 0.06 LVEDD (cm, BSA indexed) 2.5 (2.2, 2.8) 2.6 (2.3, 2.9) <0.0001 2.5 (2.2, 2.8) 2.6 (2.3, 2.9) 0.001 LVESD (cm, BSA indexed) 1.7 (1.5, 2.0) 1.8 (1.6, 2.1) <0.01 1.8 (1.5, 2.1) 1.8 (1.5, 2.1) 0.35 LA diameter (cm, BSA indexed) 2.2 (1.8, 2.5) 2.1 (1.9, 2.4) 0.31 2.2 (1.9, 2.6) 2.2 (1.9, 2.4) 0.08 Any mitral regurgitation (%) 68 73 0.03 70 71 0.76 Mitral regurgitation >moderate (%) 10 11 0.75 12 10 0.33 Aortic root (cm) 3.3 (3.0, 3.6) 3.2 (2.9, 3.5) <0.001 3.3 (3.0, 3.6) 3.2 (2.9, 3.6) 0.25 Aortic velocity (m/s) 1.4 (1.1, 1.8) 1.3 (1.1, 1.6) <0.0001 1.4 (1.1, 1.8) 1.4 (1.1, 1.7) 0.24 Aortic velocity, <3 m/s (%) 94 96 94 95 Aortic velocity, 3–4 m/s (%) 4 2 0.02 4 3 0.47 Aortic velocity, >4 m/s (%) 2 1 2 1 Any aortic regurgitation (%) 34 33 0.68 34 33 0.75 Aortic regurgitation >moderate (%) 5 2 0.01 4 3 0.56 Continuous variables were analysed using a Mann–Whitney analysis and reported as median with 25th and 75th centiles. Categorical variables were analysed using Fisher's exact test and reported as percentages. 6MWT, 6-min walk test; ACEi, angiotensin-converting enzyme inhibitors; AF, atrial fibrillation; ARB, angiotensin receptor blockers; BMI, body mass index; BPM, beats per minute; BPM, beats per minute; BSA, body surface area; COPD, chronic obstructive pulmonary disease; DBP, diastolic blood pressure; HR, heart rate; IHD, ischaemic heart disease; LA, left atrial; LVEDD, left ventricular end-diastolic diameter; LVEF, left ventricular ejection fraction; LVESD, left ventricular end-systolic diameter; LVSD, left ventricular systolic dysfunction; MRA, mineral corticoid receptor antagonist; NT-proBNP, N-terminal pro-brain natriuretic peptide; NYHA, New York Heart Failure Association; SBP, systolic blood pressure.
AbstractList For the present analysis, we focused only on patients with HF who had at their initial visit (i) a diagnosis of HF, based on symptoms and signs together with a raised N-terminal pro-brain natriuretic peptide (NT-proBNP) (≥400 ng/L) 4; (ii) LVEF ≥45%, corresponding to mild or no evidence of LVSD, as determined by echocardiography; and (iii) measurements of LVWT. HF, heart failure; LVEF, left ventricular ejection fraction; LVWT, left ventricular wall thickness; NT-proBNP, N-terminal pro-brain natriuretic peptide; SBP, systolic blood pressure. <14 mm) Age at referral (years) 78 (72, 83) 78 (72, 83) 0.54 77 (72, 82) 78 (72, 83) 0.03 Male (%) 56 45 <0.0001 59 49 0.004 BMI (kg/m2) 28 (25, 33) 27 (24, 31) 0.003 28 (25, 32) 28 (24, 32) 0.11 SBP (mmHg) 148 (130, 167) 142 (126, 163) 0.001 148 (130, 171) 145 (128, 163) 0.057 SBP < 140 mmHg (%) 38 45 0.004 39 42 0.34 DBP (mmHg) 79 (69, 89) 77 (68, 89) 0.17 79 (69, 90) 78 (68, 89) 0.59 HR (BPM) 71 (60, 84) 72 (62, 84) 0.26 69 (60, 81) 72 (61, 84) 0.89 NYHA class III/IV 32 31 0.85 29 32 0.54 6MWT (m) 288 (120, 375) 300 (135, 360) 0.88 300 (147, 375) 288 (120, 375) 0.41 ECG Heart rate (bpm) 71 (60, 84) 72 (62, 84) 0.26 69 (60, 81) 71 (61, 8) 0.08 PR interval (ms) 172 (154, 198) 168 (151, 194) 0.04 169 (154, 202) 170 (152, 196) 0.63 QRS duration (ms) 98 (88, 116) 92 (84, 108) <0.0001 100 (88, 119) 94 (84, 110) 0.0001 NT-proBNP (ng/L) 1386 (778, 2558) 1244 (776, 2256) 0.02 1497 (811, 2675) 1286 (773, 2325) 0.04 Co-morbidities AF (%) 44 48 0.13 41 47 0.08 IHD (%) 33 34 0.44 37 33 0.27 History of hypertension (%) 52 44 0.002 55 48 0.02 Diabetes (%) 27 22 0.04 32 24 0.005 COPD (%) 8 9 0.20 8 9 0.64 Treatment at referral Loop diuretics (%) 72 65 0.002 71 68 0.26 Thiazide diuretics (%) 8 8 0.93 7 8 0.63 ACEi/ARB (%) 63 61 0.44 61 63 0.68 Beta blockers (%) 56 61 0.03 51 60 0.007 MRA (%) 12 10 0.16 12 11 0.46 Echocardiography LVEF (%) 54 (48, 60) 55 (49, 60) 0.39 53 (47, 59) 55 (49, 61) 0.06 LVEDD (cm, BSA indexed) 2.5 (2.2, 2.8) 2.6 (2.3, 2.9) <0.0001 2.5 (2.2, 2.8) 2.6 (2.3, 2.9) 0.001 LVESD (cm, BSA indexed) 1.7 (1.5, 2.0) 1.8 (1.6, 2.1) <0.01 1.8 (1.5, 2.1) 1.8 (1.5, 2.1) 0.35 LA diameter (cm, BSA indexed) 2.2 (1.8, 2.5) 2.1 (1.9, 2.4) 0.31 2.2 (1.9, 2.6) 2.2 (1.9, 2.4) 0.08 Any mitral regurgitation (%) 68 73 0.03 70 71 0.76 Mitral regurgitation >moderate (%) 10 11 0.75 12 10 0.33 Aortic root (cm) 3.3 (3.0, 3.6) 3.2 (2.9, 3.5) <0.001 3.3 (3.0, 3.6) 3.2 (2.9, 3.6) 0.25 Aortic velocity (m/s) 1.4 (1.1, 1.8) 1.3 (1.1, 1.6) <0.0001 1.4 (1.1, 1.8) 1.4 (1.1, 1.7) 0.24 Aortic velocity, <3 m/s (%) 94 96 94 95 Aortic velocity, 3–4 m/s (%) 4 2 0.02 4 3 0.47 Aortic velocity, >4 m/s (%) 2 1 2 1 Any aortic regurgitation (%) 34 33 0.68 34 33 0.75 Aortic regurgitation >moderate (%) 5 2 0.01 4 3 0.56 Continuous variables were analysed using a Mann–Whitney analysis and reported as median with 25th and 75th centiles. Categorical variables were analysed using Fisher's exact test and reported as percentages. 6MWT, 6-min walk test; ACEi, angiotensin-converting enzyme inhibitors; AF, atrial fibrillation; ARB, angiotensin receptor blockers; BMI, body mass index; BPM, beats per minute; BPM, beats per minute; BSA, body surface area; COPD, chronic obstructive pulmonary disease; DBP, diastolic blood pressure; HR, heart rate; IHD, ischaemic heart disease; LA, left atrial; LVEDD, left ventricular end-diastolic diameter; LVEF, left ventricular ejection fraction; LVESD, left ventricular end-systolic diameter; LVSD, left ventricular systolic dysfunction; MRA, mineral corticoid receptor antagonist; NT-proBNP, N-terminal pro-brain natriuretic peptide; NYHA, New York Heart Failure Association; SBP, systolic blood pressure.
Author Cleland, John G.F.
Kazmi, Syed
Sarna, Harpreet S.
Brownrigg, Jack
Araghi, Marzieh
Leo, Vincenzo C.
Clark, Andrew L.
Cuthbert, Joe
Pellicori, Pierpaolo
AuthorAffiliation 4 Hull York Medical School Castle Hill Hospital Castle Rd, Cottingham Kingston upon Hull HU16 5JQ UK
2 Hull University Teaching Hospitals Trust, Castle Hill Hospital Castle Rd Cottingham HU16 5JQ UK
1 Pfizer Ltd, Walton Oaks Dorking Rd Tadworth KT20 7NS UK
3 British Heart Foundation Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health University of Glasgow Glasgow UK G12 8QQ
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Cites_doi 10.1016/j.jchf.2019.04.010
10.1093/eurheartj/ehab072
10.1002/ehf2.13961
10.1016/j.jacc.2019.09.056
10.1586/erc.10.41
10.1093/eurheartj/ehv338
10.1038/s41598-018-19507-7
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SubjectTerms Amyloid Neuropathies, Familial - diagnosis
Amyloidosis
Blood pressure
Body mass index
Chronic obstructive pulmonary disease
Diabetes
Diuretics
Ejection fraction
Heart
Heart failure
Heart rate
Humans
Hypertension
Letter to the Editor
Letters to the Editor
Peptides
Scintigraphy
Velocity
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Title Estimating nuclear scanning capacity requirements for patients with suspected cardiac transthyretin amyloidosis
URI https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fehf2.14315
https://www.ncbi.nlm.nih.gov/pubmed/36811158
https://www.proquest.com/docview/2791912520
https://search.proquest.com/docview/2779351812
https://pubmed.ncbi.nlm.nih.gov/PMC10053180
https://doaj.org/article/702fafd91f134919882747f85ec10651
Volume 10
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