Related Experiment Video

Updated: Jan 5, 2026

Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
14:19

Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction

Published on: October 14, 2016

12.0K

A novel risk score to predict survival in advanced heart failure due to cardiac amyloidosis

Michael M Kreusser1,2, Martin J Volz3, Benjamin Knop3

  • 1Division of Cardiology, Department of Internal Medicine III, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany. Michael.kreusser@med.uni-heidelberg.de.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|October 21, 2019
PubMed

Insights

A new "HeiRisk" score accurately predicts outcomes in advanced cardiac amyloidosis (AL and ATTR). This risk stratification tool, using troponin T and pulmonary artery pressure, improves upon existing models for heart failure patients.

Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Medical Diagnostics

Background:

  • Cardiac amyloidosis, including immunoglobulin light chain (AL) and transthyretin (ATTR) types, is associated with poor prognosis.
  • Existing risk scores may not accurately predict outcomes for patients with advanced heart failure due to amyloidosis, particularly those awaiting heart transplantation.
  • This study aimed to identify novel predictive parameters for severe heart failure in cardiac amyloidosis patients.

Purpose of the Study:

  • To identify predictive parameters for outcomes in patients with severe heart failure caused by cardiac amyloidosis (AL and ATTR types).
  • To develop and validate a novel risk score for risk stratification in this patient population.
  • To compare the performance of the new risk score against established models.

Main Methods:

  • Retrospective analysis of 120 cardiac amyloidosis patients (AL or ATTR) with complete cardiac assessments, including right heart catheterization, echocardiography, and biomarkers.
  • Univariate and multivariate Cox regression analyses were performed to identify independent predictors of all-cause mortality.
  • A new risk score,
  • HeiRisk
  • , was generated using identified parameters and compared to existing risk models.

Main Results:

  • For AL amyloidosis, high-sensitivity troponin T (hsTnT) and mean pulmonary artery pressure were significant independent predictors of outcomes.
  • For ATTR amyloidosis, QRS duration, hsTnT, and N-terminal pro-brain natriuretic peptide were the strongest predictors.
  • The developed
  • HeiRisk
  • score demonstrated more precise risk stratification compared to established models in the studied cohort.

Conclusions:

  • The newly developed
  • HeiRisk
  • score offers a potentially superior method for risk stratification in patients with advanced heart failure due to cardiac amyloidosis.
  • This score may enhance clinical decision-making and patient management for individuals with severe cardiac amyloidosis.
Abstract

Keywords:
BiomarkersCardiac amyloidosisHaemodynamicsHeart failurePredictors of survival

More Related Videos

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

489
A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs07:09

A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs

Published on: February 18, 2022

2.3K

Related Concept Videos

Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
277
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
651
Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
419
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
420
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
346
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
186