Abstract 3566: Elevated Troponin is Associated With Worse Cardiac Structure and Function in Patients With Systemic AL Amyloidosis
Background: Elevated troponin (Tn) has been shown to predict poor survival in patients with systemic light chain amyloidosis (AL). However, the structural and functional correlates of an elevated Tn in AL have not been well characterized by echocardiography.
Methods: Consecutive patients (N=114; 2001–2008) with cardiac involvement of AL who had baseline echocardiography and TnI testing were grouped by normal (<0.06ng/ml) and elevated (≥0.06) TnI.
Results: Patients with elevated troponin were older, more likely to be male and had higher brain natriuretic peptide (BNP) and lower creatinine clearance [Table⇓]. They had markers of LV
systolic and diastolic impairment with lower LV ejection fraction and cardiac output and higher myocardial performance index (MPI) and mitral E/A ratio. They also demonstrated indices of abnormal left atrial structure and function with higher LA volume and lower LA systolic force (LASF). Their median survival was significantly shorter.
Conclusion: In patients with cardiac AL, elevated Tn is associated with multiple echo indices of structural and functional impairment. The raised troponin level reflects myocardial injury due to the amyloidosis and correlates with alteration in cardiac anatomy and function.