Impact of tafamidis on myocardial strain in transthyretin amyloid cardiomyopathy

被引：21

作者：

Rettl, Rene ^{[1
]}

Duca, Franz ^{[1
]}

Binder, Christina ^{[1
]}

Dachs, Theresa-Marie ^{[1
]}

Cherouny, Bernhard ^{[1
]}

Ligios, Luciana Camuz ^{[1
]}

Mann, Christopher ^{[1
]}

Schrutka, Lore ^{[1
]}

Dalos, Daniel ^{[1
]}

Charwat-Resl, Silvia ^{[2
]}

Eslam, Roza Badr ^{[1
]}

Kastner, Johannes ^{[1
]}

Bonderman, Diana ^{[1
,2
]}

机构：

[1] Med Univ Vienna, Dept Internal Med 2, Div Cardiol, Waehringer Guertel 18-20, A-1090 Vienna, Austria

[2] Favoriten Clin, Dept Internal Med 5, Div Cardiol, Kundratstr 3, A-1100 Vienna, Austria

来源：

AMYLOID-JOURNAL OF PROTEIN FOLDING DISORDERS | 2023年 / 30卷 / 01期

关键词：

Transthyretin cardiac amyloidosis; tafamidis; strain echocardiography; speckle tracking; therapy monitoring; SPECKLE-TRACKING ECHOCARDIOGRAPHY; EACVI/ASE/INDUSTRY TASK-FORCE; EUROPEAN ASSOCIATION; CONSENSUS DOCUMENT; AMERICAN SOCIETY; DIAGNOSIS; GUIDELINES; ADULTS;

D O I：

10.1080/13506129.2022.2131385

中图分类号：

Q5 [生物化学]; Q7 [分子生物学];

学科分类号：

071010 ; 081704 ;

摘要：

Aims The impact of tafamidis on myocardial strain in patients with transthyretin amyloid cardiomyopathy (ATTR-CM) have been barely investigated. We aimed to determine tafamidis-induced changes using serial speckle tracking echocardiography and to identify imaging parameters for specific therapy monitoring. Methods and results ATTR-CM patients underwent serial TTE with two-dimensional (2 D) speckle tracking imaging. Patients receiving tafamidis free acid 61 mg (n = 62) or tafamidis meglumine 20 mg (n = 21) once daily (QD) showed stable measurements at follow-up (61 mg: 8.5 months, 20 mg: 7.0 months) in LV global longitudinal strain (GLS) (61 mg: -11.75% vs. -11.58%, p = 0.534; 20 mg: -10.61% vs. -10.12%, p = 0.309), right ventricular (RV) GLS (61 mg: -14.18% vs. -13.72%, p = 0.377; 20 mg: -14.53% vs. -13.99%, p = 0.452) and left atrial (LA) reservoir strain (LASr; 61 mg: 8.80% vs. 9.42%, p = 0.283; 20 mg: 8.23% vs. 8.67%, p = 0.589), whereas treatment-naive ATTR-CM patients (n = 54) had clear signs of disease progression at the end of the observation period (10.5 months; LV-GLS: -11.71% vs. -10.59%, p = 0.001; RV-GLS: -14.36% vs. -12.99%, p = 0.038; LASr: 10.67% vs. 8.41%, p = 0.005). Between-group comparison at follow-up revealed beneficial effects of tafamidis free acid 61 mg on LASr (p = 0.003) and the LV (LV-GLS: p = 0.030, interventricular septum (IVS): p = 0.006), resulting in clinical benefits (six-minute walk distance (6-MWD): p = 0.006, NT-proBNP: p= <0.001), while patients treated with tafamidis meglumine 20 mg QD showed positive effects on LASr (p = 0.039), but no differences with respect to the LV (LV-GLS: p = 0.274, IVS: p = 0.068) and clinical status (6-MWD: p = 0.124, NT-proBNP: p = 0.053) compared to the natural course. Conclusions Treatment with tafamidis free acid 61 mg in ATTR-CM patients delays the deterioration of LA and LV longitudinal function, resulting in significant clinical benefits compared with natural history. Serial TTE with 2 D speckle tracking imaging may be appropriate for disease-specific therapy monitoring.

引用

页码：127 / 137

页数：11

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