A multi-modal diagnostic model improves detection of cardiac amyloidosis among patients with diagnostic confirmation by cardiac biopsy

心脏淀粉样变性 医学 淀粉样变性 情态动词 心肌内膜活检 活检 内科学 心脏病学 放射科 病理 化学 高分子化学
作者
Kathleen W. Zhang,Ray Zhang,Elena Deych,Keith Stockerl‐Goldstein,John Gorcsan,Daniel J. Lenihan
出处
期刊:American Heart Journal [Elsevier BV]
卷期号:232: 137-145 被引量:6
标识
DOI:10.1016/j.ahj.2020.11.006
摘要

Timely recognition of cardiac amyloidosis is clinically important, but the diagnosis is frequently delayed. We sought to identify a multi-modality approach with the highest diagnostic accuracy in patients evaluated by cardiac biopsy, the diagnostic gold standard. Consecutive patients (N = 242) who underwent cardiac biopsy for suspected amyloidosis within an 18-year period were retrospectively identified. Cardiac biomarker, ECG, and echocardiography results were examined for correlation with biopsy-proven disease. A prediction model for cardiac amyloidosis was derived using multivariable logistic regression. The overall cohort was characterized by elevated BNP (median 727 ng/mL), increased left ventricular wall thickness (IWT; median 1.7 cm), and reduced voltage-to-mass ratio (median 0.06 mm/[g/m2]). One hundred and thirteen patients (46%) had either light chain (n = 53) or transthyretin (n = 60) amyloidosis by cardiac biopsy. A prediction model including age, relative wall thickness, left atrial pressure by E/e’, and low limb lead voltage (<0.5 mV) showed good discrimination for cardiac amyloidosis with an optimism-corrected c-index of 0.87 (95% CI 0.83-0.92). The diagnostic accuracy of this model (79% sensitivity, 84% specificity) surpassed that of traditional screening parameters, such as IWT in the absence of left ventricular hypertrophy on ECG (98% sensitivity, 20% specificity) and IWT with low limb lead voltage (49% sensitivity, 91% specificity). Among patients with an advanced infiltrative cardiomyopathy phenotype, traditional biomarker, ECG, and echocardiography-based screening tests have limited individual diagnostic utility for cardiac amyloidosis. A prediction algorithm including age, relative wall thickness, E/e’, and low limb lead voltage improves the detection of cardiac biopsy-proven disease.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
Glory完成签到 ,获得积分10
刚刚
1秒前
123发布了新的文献求助10
2秒前
3秒前
霍霍完成签到 ,获得积分10
3秒前
Atopos文完成签到,获得积分10
3秒前
wenqing发布了新的文献求助10
3秒前
牧星河完成签到,获得积分10
3秒前
害羞电灯胆完成签到,获得积分10
5秒前
Fang完成签到,获得积分10
5秒前
hobowei完成签到 ,获得积分10
6秒前
zyxxxx完成签到,获得积分10
6秒前
老苍完成签到,获得积分10
6秒前
hyd1640完成签到,获得积分10
7秒前
汉堡包应助1525589136采纳,获得10
7秒前
科研通AI2S应助合适的灵枫采纳,获得10
7秒前
web123发布了新的文献求助10
8秒前
w1完成签到,获得积分10
8秒前
OsHTAS完成签到,获得积分10
8秒前
cc关闭了cc文献求助
8秒前
wenqing完成签到,获得积分10
8秒前
四海完成签到,获得积分10
9秒前
杰尼龟发布了新的文献求助10
10秒前
liuqi完成签到 ,获得积分10
10秒前
流光完成签到,获得积分10
11秒前
wwww完成签到,获得积分10
11秒前
刘闹闹完成签到 ,获得积分10
11秒前
gaojing完成签到,获得积分10
12秒前
无糖零脂完成签到,获得积分10
12秒前
CC完成签到,获得积分10
12秒前
科研通AI2S应助老八的嘴采纳,获得10
13秒前
13秒前
@∞完成签到 ,获得积分10
14秒前
杰尼龟完成签到,获得积分10
14秒前
14秒前
Polaris完成签到,获得积分10
15秒前
ccyy完成签到 ,获得积分10
15秒前
研友_ngqjz8完成签到,获得积分10
15秒前
耍酷鼠标完成签到 ,获得积分0
15秒前
嘻嘻叮完成签到,获得积分10
16秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
Immigrant Incorporation in East Asian Democracies 600
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
A Preliminary Study on Correlation Between Independent Components of Facial Thermal Images and Subjective Assessment of Chronic Stress 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3968608
求助须知:如何正确求助?哪些是违规求助? 3513486
关于积分的说明 11168243
捐赠科研通 3248926
什么是DOI,文献DOI怎么找? 1794540
邀请新用户注册赠送积分活动 875188
科研通“疑难数据库(出版商)”最低求助积分说明 804676