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. 2020 Oct;43(10):1160-1166.
doi: 10.1002/clc.23426. Epub 2020 Jul 28.

Electrocardiographic parameters and prognosis of renal light chain amyloidosis

Huixian Li  1 , Ying Wang  2 , Ping Lan  1 , Liyi Xie  1 , Yanhong Zhao  3 , Wanhong Lu  1 , Guoliang Li  4
Affiliations

Electrocardiographic parameters and prognosis of renal light chain amyloidosis

Huixian Li et al. Clin Cardiol. 2020 Oct.

Abstract

Background: Cardiac involvement frequently occurs in patients with renal light chain (AL) amyloidosis, which predisposes these patients to heart failure, arrhythmia, or infarction with poor prognosis.

Hypothesis: Twelve-lead electrocardiogram (ECG) parameters may be associated with prognosis in renal AL amyloidosis.

Methods: A retrospective single-center cohort study was performed. Biopsy-proven renal AL amyloidosis patients from January 2014 to December 2018 at the First Affiliated Hospital of Xi'an Jiaotong University were enrolled. The baseline demographic information, laboratory tests, 12-lead ECG parameters at the time of diagnosis were obtained from medical records. The endpoint was defined as the time to all-cause death from baseline for all deceased patients and time to censor date (June 2019) for all other patients. Univariate and multivariate Cox proportional hazard models were conducted to identify the relationship between ECG parameters and all-cause mortality.

Results: A total of 69 patients with a mean age of 61.5 ± 11.4 years were enrolled in this study. The median PR interval and QTc interval were 160 (140, 186) and 417 ± 42 ms. The mean follow-up duration was 15.9 ± 13.8 months. Multivariate Cox regression analysis showed that regardless of adjustment for age, gender and serum creatinine, PR interval (HR 1.022, 95% CI: 1.007-1.038, P = .005), and QTc interval (HR 1.012, 95% CI: 1.004-1.021, P = .004) were independently associated with all-cause mortality.

Conclusions: PR interval and QTc interval were independently associated with all-cause mortality in renal AL amyloidosis patients. ECG parameters may provide prognostic potential of renal AL amyloidosis patients and promote the management of patients with renal AL amyloidosis.

Keywords: arrhythmia; cardiac involvement; electrocardiogram; mortality; renal light chain amyloidosis.

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Conflict of interest statement

The authors declare no potential conflict of interests.

Figures

FIGURE 1
FIGURE 1
Electrocardiogram (ECG) from a 55‐year‐old male renal AL amyloidosis patient: PR interval 198 ms, QTc interval 476 ms, low limb voltage
FIGURE 2
FIGURE 2
Diffuse glomerular deposition of amorphous material in the mesangium and the capillary loops, A, PAS staining. B, PASM and Masson staining. C, Congo red staining. Immunofluorescence microscopy. D, Positive for lambda light chains. E, Negative for Kappa light chains
FIGURE 3
FIGURE 3
A, Kaplan‐Meier survival curves according to the presence of prolonged PR interval (>160 ms), log rank P = .006. B, Kaplan‐Meier survival curves according to the presence of prolonged QTc interval (>417 ms), log rank P = .003
FIGURE 4
FIGURE 4
The QTc interval showed satisfactory predictive values for overall survival in renal AL amyloidosis (P = .001)
See this image and copyright information in PMC

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References

    1. Quock TP, Yan T, Chang E, Guthrie S, Broder MS. Epidemiology of AL amyloidosis: a real‐world study using US claims data. Blood Adv. 2018;2(10):1046‐1053. 10.1182/bloodadvances.2018016402. - DOI - PMC - PubMed
    1. Kyle RA, Larson DR, Kurtin PJ, et al. Incidence of AL amyloidosis in Olmsted County, Minnesota, 1990 through 2015. Mayo Clin Proc. 2019;94(3):465‐471. 10.1016/j.mayocp.2018.08.041. - DOI - PMC - PubMed
    1. Dember LM. Amyloidosis‐associated kidney disease. J Am Soc Nephrol. 2006;17(12):3458‐3471. 10.1681/ASN.2006050460. - DOI - PubMed
    1. Gertz MA, Lacy MQ, Dispenzieri A. Immunoglobulin light chain amyloidosis and the kidney. Kidney Int. 2002;61(1):1‐9. 10.1046/j.1523-1755.2002.00085.x. - DOI - PubMed
    1. Buss SJ, Emami M, Mereles D, et al. Longitudinal left ventricular function for prediction of survival in systemic light‐chain amyloidosis: incremental value compared with clinical and biochemical markers. J Am Coll Cardiol. 2012;60(12):1067‐1076. 10.1016/j.jacc.2012.04.043. - DOI - PubMed