1
|
Ferraro RA, Ogunmoroti O, Zhao D, Ndumele CE, Lima JA, Varadarajan V, Subramanya V, Pandey A, Larson NB, Bielinski SJ, Michos ED. Hepatocyte Growth Factor and 10-year Change in Left Ventricular Structure: The Multi-Ethnic Study of Atherosclerosis. CJC Open 2023. [DOI: 10.1016/j.cjco.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
|
2
|
Lyon AR, López-Fernández T, Couch LS, Asteggiano R, Aznar MC, Bergler-Klein J, Boriani G, Cardinale D, Cordoba R, Cosyns B, Cutter DJ, de Azambuja E, de Boer RA, Dent SF, Farmakis D, Gevaert SA, Gorog DA, Herrmann J, Lenihan D, Moslehi J, Moura B, Salinger SS, Stephens R, Suter TM, Szmit S, Tamargo J, Thavendiranathan P, Tocchetti CG, van der Meer P, van der Pal HJH. 2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS). Eur Heart J 2022; 43:4229-4361. [PMID: 36017568 DOI: 10.1093/eurheartj/ehac244] [Citation(s) in RCA: 612] [Impact Index Per Article: 306.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
|
3
|
Lyon AR, López-Fernández T, Couch LS, Asteggiano R, Aznar MC, Bergler-Klein J, Boriani G, Cardinale D, Cordoba R, Cosyns B, Cutter DJ, de Azambuja E, de Boer RA, Dent SF, Farmakis D, Gevaert SA, Gorog DA, Herrmann J, Lenihan D, Moslehi J, Moura B, Salinger SS, Stephens R, Suter TM, Szmit S, Tamargo J, Thavendiranathan P, Tocchetti CG, van der Meer P, van der Pal HJH. 2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS). Eur Heart J Cardiovasc Imaging 2022; 23:e333-e465. [PMID: 36017575 DOI: 10.1093/ehjci/jeac106] [Citation(s) in RCA: 78] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
|
4
|
Perfetto F, Zampieri M, Fumagalli C, Allinovi M, Cappelli F. Circulating biomarkers in diagnosis and management of cardiac amyloidosis: a review for internist. Intern Emerg Med 2022; 17:957-969. [PMID: 35325395 PMCID: PMC9135845 DOI: 10.1007/s11739-022-02958-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/23/2022] [Indexed: 12/12/2022]
Abstract
Cardiac amyloidosis (CA) is due to extracellular myocardial deposition of misfolded proteins resulting in severe cardiac dysfunction and death. The precursors of amyloid fibrils, able of determining a relevant cardiac infiltration, are immunoglobulin-free light chains (AL amyloidosis) and transthyretin (TTR) (both wild and mutated types). The diagnosis of amyloidosis represents a challenge for the clinician given its rarity and its protean clinical presentation, thus an early diagnosis remains a cornerstone for the prognosis of these patients, also in light of the growing available treatments. There is great interest in identifying and applying biomarkers to help diagnose, inform prognosis, guide therapy, and serve as surrogate endpoints in these patients. In AL amyloidosis, biomarkers such as free light chains, natriuretic peptides and troponins are the most extensively studied and validated; they have proved useful in risk stratification, guiding treatment choice and monitoring hematological and organ response. A similar biomarker-based prognostic score is also proposed for ATTR amyloidosis, although studies are small and need to be validated for wild-type and mutant forms.
Collapse
Affiliation(s)
- Federico Perfetto
- Regional Referral Center for Systemic Amyloidosis, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
| | - Mattia Zampieri
- Regional Referral Center for Systemic Amyloidosis, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Carlo Fumagalli
- Regional Referral Center for Systemic Amyloidosis, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Marco Allinovi
- Regional Referral Center for Systemic Amyloidosis, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Francesco Cappelli
- Regional Referral Center for Systemic Amyloidosis, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| |
Collapse
|
5
|
Chen Y, Liu J, Qiao T, Xie M, Cai Z, Zhou J, Ergün S. Prognostic Value of a Novel Parameter in Patients with Infective Endocarditis. BioMed Research International 2022; 2022:1-5. [PMID: 35463994 PMCID: PMC9020976 DOI: 10.1155/2022/1042780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/31/2022] [Indexed: 11/18/2022]
Abstract
Background Infective endocarditis (IE) has a high rate of mortality and the prognosis of IE was poor. The purpose of this investigation was to explore the value of lactate dehydrogenase (LDH)/lymphocyte and compare it with LDH/lymphocyte percentage (L-LWR) in predicting the in-hospital mortality in IE patients. Methods The investigation cohort contained 147 IE patients between January 2017 and December 2019. We retrospectively went over the medical records and selected admission indexes. Results Compared with IE patients with adverse events, significantly higher levels of LDH/lymphocyte and significantly lower levels of L-LWR were discovered in IE patients without adverse events. After adjustments, L-LWR (odds ratio (OR): 4.558, 95% confidence interval (CI) 1.362-15.256, P = 0.014) still maintained its significant independence. In addition, L-LWR had the highest area under curve (AUC) (0.780, 0.704-0.844, P < 0.001) with good sensitivity (81.89%) and specificity (65.00%) when 34 was selected as the best cutoff value. Conclusions L-LWR is a reliable, low-priced, easily applicable, and independent prognostic parameter for in-hospital death with good performance in patients with IE.
Collapse
|
6
|
Witteles R, Ky B. Cardiac Amyloidosis: The "Tipping Point" Has Been Reached. JACC CardioOncol 2021; 3:617-618. [PMID: 34729539 PMCID: PMC8543130 DOI: 10.1016/j.jaccao.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
7
|
Zhang KW, Vallabhaneni S, Alvarez-Cardona JA, Krone RJ, Mitchell JD, Lenihan DJ. Cardiac Amyloidosis for the Primary Care Provider: A Practical Review to Promote Earlier Recognition of Disease. Am J Med 2021; 134:587-595. [PMID: 33444590 DOI: 10.1016/j.amjmed.2020.11.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 11/28/2020] [Accepted: 11/30/2020] [Indexed: 12/19/2022]
Abstract
Cardiac amyloidosis is increasingly recognized as an underdiagnosed cause of heart failure. Diagnostic delays of up to 3 years from symptom onset may occur, and patients may be evaluated by more than 5 specialists prior to receiving the correct diagnosis. Newly available therapies improve clinical outcomes by preventing amyloid fibril deposition and are usually more effective in early stages of disease, making early diagnosis essential. Better awareness among primary care providers of the clinical presentation and modern treatment landscape is essential to improve timely diagnosis and early treatment of this disease. In this review, we provide practical guidance on the epidemiology, clinical manifestations, diagnostic evaluation, and treatment of transthyretin and light chain cardiac amyloidosis to promote earlier disease recognition among primary care providers.
Collapse
Affiliation(s)
- Kathleen W Zhang
- Cardio-Oncology Center of Excellence, Washington University School of Medicine, St Louis Mo.
| | | | - Jose A Alvarez-Cardona
- Cardio-Oncology Center of Excellence, Washington University School of Medicine, St Louis Mo
| | - Ronald J Krone
- Cardio-Oncology Center of Excellence, Washington University School of Medicine, St Louis Mo
| | - Joshua D Mitchell
- Cardio-Oncology Center of Excellence, Washington University School of Medicine, St Louis Mo
| | - Daniel J Lenihan
- Cardio-Oncology Center of Excellence, Washington University School of Medicine, St Louis Mo
| |
Collapse
|
8
|
Castiglione V, Franzini M, Aimo A, Carecci A, Lombardi CM, Passino C, Rapezzi C, Emdin M, Vergaro G. Use of biomarkers to diagnose and manage cardiac amyloidosis. Eur J Heart Fail 2021; 23:217-230. [PMID: 33527656 DOI: 10.1002/ejhf.2113] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 11/28/2020] [Accepted: 01/25/2021] [Indexed: 12/22/2022] Open
Abstract
Amyloidoses are characterized by the tissue accumulation of misfolded proteins into insoluble fibrils. The two most common types of systemic amyloidosis result from the deposition of immunoglobulin light chains (AL) and wild-type or variant transthyretin (ATTRwt/ATTRv). Cardiac involvement is the main determinant of outcome in both AL and ATTR, and cardiac amyloidosis (CA) is increasingly recognized as a cause of heart failure. In CA, circulating biomarkers are important diagnostic tools, allow to refine risk stratification at baseline and during follow-up, help to tailor the therapeutic strategy and monitor the response to treatment. Among amyloid precursors, free light chains are established biomarkers in AL amyloidosis, while the plasma transthyretin assay is currently being investigated as a tool for supporting the diagnosis of ATTRv amyloidosis, predicting outcome and monitor response to novel tetramer stabilizers or small interfering RNA drugs in ATTR CA. Natriuretic peptides (NPs) and troponins are consistently elevated in patients with AL and ATTR CA. Plasma NPs, troponins and free light chains hold prognostic significance in AL amyloidosis, and are evaluated for therapy decision-making and follow-up, while the value of NPs and troponins in ATTR is less well established. Biomarkers can be usefully integrated with clinical and imaging variables at all levels of the clinical algorithm of systemic amyloidosis, from screening to diagnosis and prognosis, and treatment tailoring.
Collapse
Affiliation(s)
| | - Maria Franzini
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Alberto Aimo
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.,Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | | | - Carlo Mario Lombardi
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health University and Civil Hospital, Brescia, Italy
| | - Claudio Passino
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.,Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Claudio Rapezzi
- Centro Cardiologico Universitario di Ferrara, University of Ferrara, Ferrara, Italy.,Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
| | - Michele Emdin
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.,Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Giuseppe Vergaro
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.,Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| |
Collapse
|
9
|
Alvarez-Cardona JA, Zhang KW, Mitchell JD, Zaha VG, Fisch MJ, Lenihan DJ. Cardiac Biomarkers During Cancer Therapy: Practical Applications for Cardio-Oncology. JACC CardioOncol 2020; 2:791-794. [PMID: 34396295 PMCID: PMC8352269 DOI: 10.1016/j.jaccao.2020.08.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/19/2020] [Accepted: 08/21/2020] [Indexed: 01/16/2023]
Key Words
- BNP, B-type natriuretic peptide
- CV, cardiovascular
- ECG, electrocardiography
- EMBx, endomyocardial biopsy
- GLS, global longitudinal strain
- HF, heart failure
- HFpEF, heart failure with preserved ejection fraction
- LGE, late gadolinium enhancement
- LV, left ventricular
- LVEF, left ventricular ejection fraction
- NP, natriuretic peptide
- NT-proBNP, N-terminal pro–B-type natriuretic peptide
- TTE, transthoracic echocardiography
- amyloidosis
- anthracyclines
- biomarkers
- cMRI, cardiac magnetic resonance imaging
- cardiotoxicity
- chemotherapy
- detection
Collapse
Affiliation(s)
- Jose A. Alvarez-Cardona
- Cardio-Oncology Center of Excellence, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Kathleen W. Zhang
- Cardio-Oncology Center of Excellence, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Joshua D. Mitchell
- Cardio-Oncology Center of Excellence, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Vlad G. Zaha
- Division of Cardiology, Department of Internal Medicine, Harold C. Simmons Comprehensive Cancer Center and Advanced Imaging Research Center, University of Texas Southwestern, Dallas, Texas, USA
| | - Michael J. Fisch
- Department of General Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Daniel J. Lenihan
- Cardio-Oncology Center of Excellence, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, USA
- Address for correspondence: Dr. Daniel J Lenihan, Cardio-Oncology Center of Excellence, Cardiovascular Division, Washington University in St. Louis, 660 South Euclid Avenue, Campus Box 8086, St. Louis, Missouri 63110. @ICOSociety
| |
Collapse
|