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

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.