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First-phase ejection fraction as a potential early indicator for left ventricular function in cardiac amyloidosis.

Tongtong Huang1, Chunxiao Su1, Chunlan Jiang1

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Left ventricular first-phase ejection fraction (LVEF1) is a sensitive indicator for cardiac amyloidosis (CA). Lower baseline LVEF1 predicts poor prognosis in light-chain CA patients, aiding treatment decisions.

Keywords:
First-phase ejection fractioncardiac amyloidosis (CA)left ventricle

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Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Hematology

Background:

  • Cardiac amyloidosis (CA) significantly impacts prognosis in light-chain amyloidosis.
  • Left ventricular first-phase ejection fraction (LVEF1) is a more sensitive indicator than ejection fraction for CA.
  • This study investigates the utility of LVEF1 in guiding treatment and prognosis for light-chain CA.

Purpose of the Study:

  • To evaluate the role of LVEF1 in assessing left ventricular function in patients with suspected cardiac amyloidosis.
  • To determine the prognostic value of LVEF1 in light-chain cardiac amyloidosis.
  • To assess the impact of treatment on LVEF1 and its correlation with treatment response.

Main Methods:

  • 119 patients with light-chain amyloidosis and suspected CA were enrolled.
  • Diagnosis was confirmed via cardiac magnetic resonance or abdominal fat biopsy.
  • LVEF1, echocardiography, and biochemical data were analyzed pre- and post-chemotherapy.

Main Results:

  • Patients with CA had significantly lower baseline LVEF1 compared to non-CA patients (31.35% vs. 36.25%).
  • LVEF1 improved in patients achieving hematologic complete response (hemCR) after treatment (32.62% to 39.24%).
  • Baseline LVEF1 <30% was associated with elevated NT-proBNP, reduced GLS, and increased mortality risk.

Conclusions:

  • LVEF1 serves as an early indicator of left ventricular dysfunction in CA patients with preserved ejection fraction.
  • LVEF1 can detect subtle changes in cardiac function and predict prognosis.
  • LVEF1 is a valuable tool for managing light-chain cardiac amyloidosis.