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Prognostic value of cardiopulmonary exercise testing in cardiac amyloidosis

European Journal of Heart Failure Nov 25, 2020

Nicol M, Deney A, Lairez O, et al. - Researchers performed a multicentre study to determine how functional evaluation and risk stratification in patients with cardiac amyloidosis (CA) could be assisted by cardiopulmonary exercise test (CPET). Participants were cases with light chain or transthyretin CA. All patients received an exhaustive assessment including CPET and follow‐up. The occurrence of death or heart failure hospitalization was the primary prognostic endpoint. A median follow‐up of 20 months revealed the occurrence of 37 deaths and 44 heart failure hospitalizations. In multivariate Cox analysis, the factors that were shown to be related to the primary outcome were: peak VO2(peak oxygen consumption) ≤ 13 mL/kg/min, circulatory power ≤ 1730 mmHg/mL/min and N‐terminal pro B‐type natriuretic peptide ≥ 1800 ng/L. Based on the findings, experts concluded that CPET affords a tool that aids the assessment of functional capacity, circulatory and chronotropic responses as well as the prognosis of patients, along with cardiac biomarkers, in CA.

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