Abstract 12554: The Association of Electrocardiographic Findings With Outcomes in Cardiac Amyloidosis
Introduction: Classically, electrocardiogaphic (EKG) findings in patients with cardiac amyloidosis include low voltage and pseudoinfarcts. While these findings may be clues to the diagnosis, the association of EKG findings with outcomes is poorly delineated. We sought to determine the association of EKG findings with outcomes (.e.g hospitalization, orthotopic heart transplantation (OHT) and death) in patients with cardiac amyloid
Method: The 12 lead EKG in 200 patients with diagnosed cardiac amyloidosis: 110 primary (AL), 45 hereditary (ATTRmt), and 45 senile (ATTRwt) were reviewed by a single observer (NBC). The association of EKG findings with outcomes was assessed by a cox proportional hazards model. Multivariate analysis was performed to determine if EKG/echocardiograph findings were independently associated with time to first outcome.
Results: Over a mean follow-up period of 616 days (range 6-4660 days), 72 patients required hospitalization, 78 died and 25 underwent OHTs. Overall, 125 (63%) had an at least one of these events. The results of univariate and multivariate analyses are shown in the table below.
Sokolow ≤ 15mm (HR 1.690; 95% CI of 1.069 - 2.672; p = 0.0246) was independently associated with adverse outcomes in a model including age, gender, type of amyloid, and low limb voltage.
Conclusion: In cardiac AL amyloidosis the prevalence of low QRS voltages is highly dependent on the method used for defining this EKG alteration with Sokolow-Lyon index ≤15 mm being most sensitive. Electrocardiographic indices of QRS voltage are associated with adverse outcomes in cardiac amyloidosis.
- © 2013 by American Heart Association, Inc.