Atrial Mechanical Contraction Predicts Cerebrovascular Risk in Patients With Transthyretin Amyloid Cardiomyopathy and Sinus Rhythm - PubMed
4 days ago
- #cardiomyopathy
- #stroke
- #anticoagulation
- Atrial mechanical contraction predicts cerebrovascular risk in patients with transthyretin amyloid cardiomyopathy (ATTR-CM) and sinus rhythm (SR).
- Left atrial (LA) dysfunction, particularly atrial electromechanical dissociation (AEMD) and severely impaired left atrial strain contraction (LASc), is associated with increased cerebrovascular events.
- Patients with AEMD had a 3-fold higher risk of stroke or transient ischemic attack (TIA) compared to those with LA mechanical contraction.
- LASc tertiles (<4%, 4%-7%, >7%) showed an independent association with 1-year risk of stroke or TIA, with LASc <4% linked to a 10-fold increased risk compared to LASc >7%.
- Adding LASc tertiles to CHA2DS2-VASc or CHA2DS2-VA improved risk stratification and reclassification at 1 year.
- The study suggests LAS analysis may help identify ATTR-CM patients in SR who could benefit from intensified rhythm monitoring or prophylactic anticoagulation.