109 Left atrium enlargement is an independent predictor of overall mortality in patients with systemic amyloidosis

BackgroundPrimary systemic amyloidosis (AL) is a severe plasma cell disorder characterized by amyloid fibrils extracellular deposition in different organs. Myocardial involvement is frequent and has major impact on prognosis. Echocardiography (TTE) is the most common test performed when cardiac involvement is suspected. We hypothesized that a simple measurement of left atrium enlargement (LA) by TTE may provide an important risk marker for this disease.Methods and resultsBetween 1997 and 2010, 109 patients were diagnosed with systemic AL and had first TTE within 21 days. Patients were mainly treated with conventional chemotherapy (M-Dex) with new agents for refractory or relapsing patients We retrospectively collected demographic baseline characteristics along with biological and echo data of these patients. Mean age was 63±11 years; 58% were male; 24% had hypertension. Mean left ventricular ejection fraction and mean LV wall thickness were respectively 62±13% and 13±3mm. Mean follow up time was 2.42±2 years. None had significant valvular heart disease. LA enlargement was defined by M mode as > 40mm in male and > 36mm in female. Patients with enlarged LA were more often male, slightly older (p=0.05) and with slightly more hypertension (p=0.07) but had significantly lower ejection fraction and more hypertrophied LV walls (All P