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 in | ESC Heart Failure Vol. 10; no. 2; pp. 1492 - 1496 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
England
John Wiley & Sons, Inc
01.04.2023
John Wiley and Sons Inc Wiley |
Subjects | |
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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. |
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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 |
AuthorAffiliation_xml | – name: 1 Pfizer Ltd, Walton Oaks Dorking Rd Tadworth KT20 7NS UK – name: 3 British Heart Foundation Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health University of Glasgow Glasgow UK G12 8QQ – name: 2 Hull University Teaching Hospitals Trust, Castle Hill Hospital Castle Rd Cottingham HU16 5JQ UK – name: 4 Hull York Medical School Castle Hill Hospital Castle Rd, Cottingham Kingston upon Hull HU16 5JQ UK |
Author_xml | – sequence: 1 givenname: Vincenzo C. surname: Leo fullname: Leo, Vincenzo C. organization: Pfizer Ltd, Walton Oaks – sequence: 2 givenname: Syed surname: Kazmi fullname: Kazmi, Syed organization: Hull University Teaching Hospitals Trust, Castle Hill Hospital – sequence: 3 givenname: Jack surname: Brownrigg fullname: Brownrigg, Jack organization: Pfizer Ltd, Walton Oaks – sequence: 4 givenname: Marzieh surname: Araghi fullname: Araghi, Marzieh email: marzieh.araghi@pfizer.com organization: Pfizer Ltd, Walton Oaks – sequence: 5 givenname: Harpreet S. surname: Sarna fullname: Sarna, Harpreet S. organization: Pfizer Ltd, Walton Oaks – sequence: 6 givenname: Pierpaolo surname: Pellicori fullname: Pellicori, Pierpaolo organization: University of Glasgow – sequence: 7 givenname: Joe surname: Cuthbert fullname: Cuthbert, Joe organization: Hull York Medical School Castle Hill Hospital – sequence: 8 givenname: John G.F. surname: Cleland fullname: Cleland, John G.F. organization: University of Glasgow – sequence: 9 givenname: Andrew L. surname: Clark fullname: Clark, Andrew L. organization: Hull University Teaching Hospitals Trust, Castle Hill Hospital |
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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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Copyright | 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. 2023. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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References | e_1_2_1_4_4_1 e_1_2_1_4_6_1 e_1_2_1_4_7_1 e_1_2_1_4_9_1 e_1_2_1_4_8_1 e_1_2_1_4_10_1 Al‐Mohammad A (e_1_2_1_4_5_1) 2018; 362 e_1_2_1_4_2_1 e_1_2_1_4_3_1 |
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Snippet | 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... |
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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 |
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