Unveiling Cardiac Amyloidosis, its Characteristics, and Outcomes Among Patients With MR Undergoing Transcatheter Edge-to-Edge MV Repair

• DOI: 10.1016/j.jcin.2022.06.009
• Publication Date: 2022-08-22T07:01:46Z
• Authors: Carolina Donà; Christian Nitsche; Matthias Koschutnik; Gregor Heitzinger; Katharina Mascher...; Andreas A. Kammer...; Varius Dannenberg; Kseniya Halavina; René Rettl; Franz Duca; Tatjana Traub-Wei...; Juergen Puchinger; Petra C. Gunacker; Gudrun Lamm; Paul Vock; Brigitte Lileg; Vyhnanek Philipp; Anton Staudenherz; Raffaella Calabretta; Marcus Hacker; Hermine Agis; Philipp Bartko; Christian Hengste...; Marianna Fontana; Georg Goliasch; Julia Mascherbauer
• Keywords: Cardiac Amyloidosis; Concomitant; AL amyloidosis

Mitral regurgitation (MR) and cardiac amyloidosis (CA) both primarily affect older patients. Data on coexistence prognostic implications of MR CA are currently lacking. This study sought to identify the prevalence, clinical characteristics, outcomes compared with lone MR. Consecutive patients undergoing transcatheter edge-to-edge repair (TEER) for at 2 sites were screened concomitant using a multiparametric approach including core laboratory 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid bone scintigraphy echocardiography immunoglobulin light chain assessment. Transthyretin (ATTR) was diagnosed by (Perugini grade 1: early infiltration; grades 2/3: CA) absence monoclonal protein, (AL) via tissue biopsy. All-cause mortality hospitalization heart failure (HHF) served as endpoints. A total 120 (age 76.9 ± 8.1 years, 55.8% male) recruited. Clinical in 14 (11.7%; 12 ATTR, 1 AL, combined ATTR/AL) amyloid infiltration 9 (7.5%). Independent predictors increased posterior wall thickness presence left anterior fascicular block electrocardiography. Procedural success periprocedural complications TEER similar (P all = NS). After median 1.7 25.8% had experienced death and/or HHF. worse (HR: 2.2; 95% CI: 1.0-4.7; P 0.034), driven 2.5-fold higher risk HHF 2.5; 1.1-5.9), but comparable 1.6; 0.4-6.1). Dual pathology is common elderly has postinterventional