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Comparison of Patterns of Coronary Artery Disease in Patients With Heart Failure by Cardiac Amyloidosis Status

Solomon S Beyene1, Omar Yacob2, Gebremedhin D Melaku1

  • 1MedStar Washington Hospital Center-Cardiology Department, USA.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|October 3, 2020
PubMed

Insights

Cardiac amyloidosis patients with heart failure are older but show fewer calcified and ostial coronary lesions. This study reveals distinct coronary artery patterns in heart failure with cardiac amyloidosis.

Area of Science:

  • Cardiology
  • Cardiovascular Diseases
  • Medical Imaging

Background:

  • Cardiac amyloidosis is a progressive disease that affects the heart.
  • Heart failure is a common complication of cardiac amyloidosis.
  • Coronary artery lesions can impact heart function and patient outcomes.

Purpose of the Study:

  • To characterize the pattern and severity of coronary artery lesions in patients with cardiac amyloidosis.
  • To compare coronary angiographic findings between heart failure patients with (HF/CA+) and without (HF/CA-) cardiac amyloidosis.

Main Methods:

  • Retrospective comparison of 110 heart failure patients (55 HF/CA+, 55 HF/CA-).
  • Demographic and angiographic data were analyzed for qualitative and quantitative variables.
  • Focus on major epicardial coronary vessels to determine patterns of involvement.

Main Results:

  • HF/CA+ patients were older (74.5 vs 54.1 years) but had significantly less severe calcification (0.0% vs 4.5%) and fewer ostial lesions (3.4% vs 15.1%).
  • HF/CA+ group showed a trend towards higher Thrombolysis in Myocardial Infarction (TIMI) frame count (30.4 vs 26.6), indicating reduced coronary blood flow.
  • Men in the HF/CA+ group had more tandem lesions compared to women (14.5% vs 0.0%).

Conclusions:

  • Heart failure patients with cardiac amyloidosis exhibit unique coronary lesion characteristics: older age, less calcification, reduced ostial involvement, and diminished coronary blood flow.
  • This is the first study to specifically examine coronary lesions in the context of heart failure with cardiac amyloidosis.
  • Findings suggest that cardiac amyloidosis influences coronary artery pathology differently than typical atherosclerosis.
Abstract

Keywords:
Cardiac amyloidosisCoronary angiographyHeart failure

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