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Naji, M. |
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Motta, Antonella |
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Aletan, Dirar |
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Mohamed, Tarek |
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Ertürk, Emre |
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Taccardi, Nicola |
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Kononenko, Denys |
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Petrov, R. H. | Madrid |
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Alshaaer, Mazen | Brussels |
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Bih, L. |
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Casati, R. |
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Muller, Hermance |
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Kočí, Jan | Prague |
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Šuljagić, Marija |
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Kalteremidou, Kalliopi-Artemi | Brussels |
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Azam, Siraj |
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Ospanova, Alyiya |
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Blanpain, Bart |
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Ali, M. A. |
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Popa, V. |
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Rančić, M. |
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Ollier, Nadège |
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Azevedo, Nuno Monteiro |
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Landes, Michael |
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Rignanese, Gian-Marco |
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Kronberger, Christina
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article
Cardiopulmonary exercise testing in transthyretin amyloid cardiomyopathy patients: a long-term follow-up study
Abstract
<jats:sec><jats:title>Aims</jats:title><jats:p>Patients with transthyretin amyloid cardiomyopathy (ATTR-CM) experience reduced functional capacity. We evaluated changes in functional capacity over extensive follow-up using cardiopulmonary exercise testing (CPX).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>ATTR-CM patients underwent CPX and blood testing at baseline, first [V1, 8 (6–10) months] and second follow-up (V2) at 35 (26–41) months after start of disease-specific therapy.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>We included 34 ATTR-CM patients, aged 77 (±6) years (88.2% men). CPX showed two patterns with functional capacity improvement at V1 and deterioration at V2. Peak work capacity (<jats:italic toggle="yes">P</jats:italic> = 0.005) and peak oxygen consumption (VO<jats:sub>2</jats:sub>, <jats:italic toggle="yes">P</jats:italic> = 0.012) increased at V1 compared with baseline and decreased at V2. The ventilation to carbon dioxide relationship slope (VE/VCO<jats:sub>2</jats:sub>) increased at V2 compared with baseline and V1 (<jats:italic toggle="yes">P</jats:italic> = 0.044). A cut-off for peak VO<jats:sub>2</jats:sub> at 14 ml/kg·min showed more events (composite of death and heart failure hospitalization): less than 14 vs. greater than 14 ml/kg·min (<jats:italic toggle="yes">P</jats:italic> = 0.013). Cut-offs for VE/VCO<jats:sub>2</jats:sub> slope at 40 showed more events greater than 40 vs. less than 40 (<jats:italic toggle="yes">P</jats:italic> = 0.009).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>ATTR-CM patients showed an improvement and deterioration in the short-term and long-term follow-up, respectively, with a better prognosis for those with peak VO<jats:sub>2</jats:sub> above 14 ml/kg·min and for a VE/VCO<jats:sub>2</jats:sub> slope below 40.</jats:p></jats:sec>