Low QRS Voltages in Cardiac Amyloidosis

• DOI: 10.1016/j.jaccao.2022.08.007
• Publication Date: 2022-09-07T11:25:05Z
• Authors: Alberto Cipriani; Laura De Michieli; Aldostefano Porcari; Luca Licchelli; Giulio Sinigiani; Giacomo Tini; Mattia Zampieri; Eugenio Sessarego; Alessia Argirò; Carlo Fumagalli; Monica De Gaspari; Roberto Licordari; Domitilla Russo; Gianluca Di Bella; Federico Perfetto; Camillo Autore; Beatrice Musumeci; Marco Canepa; Marco Merlo; Gianfranco Sinagra; Dario Gregori; Sabino Iliceto; Martina Perazzolo...; Francesco Cappelli; Claudio Rapezzi
• Keywords: Cardiac Amyloidosis; AL amyloidosis

Low QRS voltages (LQRSVs) are a common electrocardiographic feature in patients with light chain amyloidosis (AL) and transthyretin (ATTR) cardiac (CA).The aim of this study was to identify clinical echocardiographic correlates LQRSV investigate their prognostic significance CA.This multicenter, retrospective performed 6 CA referral centers including consecutive AL ATTR CA. LQRSVs were defined as amplitude ≤5 mm (0.5 mV) all peripheral leads. The outcome cardiovascular (CV) mortality.Overall, 411 (AL CA: n = 120, 291) included. present 66 (55%) 103 (35%) (P < 0.001). In CA, independently associated younger age 0.015), higher New York Heart Association functional class 0.016), natriuretic peptides 0.041); pericardial effusion 0.008) lower tricuspid annulus peak systolic excursion 0.038). During median follow-up 33 months (Q1-Q3: 21-46), predicted CV death both (HR: 1.76; 95% CI: 2.41-10.18; P 0.031) 2.64; 1.82-20.17; 0.005). Together the National Amyloidosis Centre (NAC) staging, provided incremental value (AUC for NAC model: 0.83 [95% 0.77-0.89]; AUC + 0.87 0.81-0.93]; 0.040).LQRSVs but not ubiquitous CA; they more frequent than reflect an advanced disease stage predict death. can provide accuracy over staging system intermediate risk.