Frailty in Older Patients with Transthyretin Cardiac Amyloidosis

Cazalbou, Stéphanie; Naccache, Louise; Sourdet, Sandrine; Cariou, Eve; Fournier, Pauline; Nourhashemi, Fati; Balardy, Laurent; Toulza, Olivier; Lairez, Olivier; Steinmeyer, Zara; on behalf of the Toulouse Amyloidosis Research Network,

doi:10.3390/jcm12247507

Open AccessArticle

Frailty in Older Patients with Transthyretin Cardiac Amyloidosis

by

Stéphanie Cazalbou

^1,2,

Louise Naccache

³,

Sandrine Sourdet

³,

Eve Cariou

^1,2,

Pauline Fournier

^1,2,

Fati Nourhashemi

^3,4,5,

Laurent Balardy

^3,4,

Olivier Toulza

³,

Olivier Lairez

^1,2,5,6,*

,

Zara Steinmeyer

³ and

on behalf of the Toulouse Amyloidosis Research Network

^†

¹

Department of Cardiology, University Hospital of Toulouse, 31400 Toulouse, France

²

Cardiac Imaging Center, University Hospital of Toulouse, 31059 Toulouse, France

³

Geriatrics Department, Internal Medicine and Cardiogeriatry Unit, Toulouse University Hospital, 31059 Toulouse, France

⁴

French National Institute of Health and Medical Research, Toulouse III Paul Sabatier University, 31062 Toulouse, France

⁵

Medical School of Medicine, Toulouse III Paul Sabatier University, 31062 Toulouse, France

⁶

Department of Nuclear Medicine, University Hospital of Toulouse, 31059 Toulouse, France

^*

Author to whom correspondence should be addressed.

^†

Collaborators of the Toulouse Amyloidosis Research Network is provided in Acknowledgments.

J. Clin. Med. 2023, 12(24), 7507; https://doi.org/10.3390/jcm12247507

Submission received: 19 October 2023 / Revised: 22 November 2023 / Accepted: 30 November 2023 / Published: 5 December 2023

(This article belongs to the Special Issue New Insights in Cardiac Amyloidosis and Its Complications)

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Abstract

Background—Transthyretin cardiac amyloidosis (ATTR-CA) prevalence increases with age. The interplay between frailty and heart failure has been increasingly recognized. The objective of this study is to compare clinical, biological, and transthoracic echocardiography (TTE) characteristics of older ATTR-CA patients according to the G8 frailty screening tool. Methods—Patients over 75 years old with a confirmed diagnosis of ATTR-CA were included between January 2020 and April 2021. All patients underwent a routine blood test, TTE, and a functional assessment with a six-minute walking distance test (6MWD) or cardiopulmonary exercise testing (CPET), and the G8 score was calculated. Results—Fifty-two patients were included. Thirty-nine (75%) patients were frail and their mean NYHA stage was more severe (2.2 vs. 1.7; p = 0.004); 62% of them had a Gilmore stage of 2 or 3 (p = 0.05). Global left ventricular strain (GLS) was lower (−11.7% vs. −14.9%; p = 0.014) and the interventricular septum was thicker (18 ± 2 mm vs. 17 ± 2 mm; p = 0.033) in frail patients. There were no significant differences according to functional tests. Conclusion—The majority of older patients with ATTR-CA are frail according to the G8 score. They are more symptomatic and have an increased cardiac involvement and a poorer prognosis, requiring more personalized cardiac management.

Keywords: ATTR cardiac amyloidosis; frailty; G8 score

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MDPI and ACS Style

Cazalbou, S.; Naccache, L.; Sourdet, S.; Cariou, E.; Fournier, P.; Nourhashemi, F.; Balardy, L.; Toulza, O.; Lairez, O.; Steinmeyer, Z.; et al. Frailty in Older Patients with Transthyretin Cardiac Amyloidosis. J. Clin. Med. 2023, 12, 7507. https://doi.org/10.3390/jcm12247507

AMA Style

Cazalbou S, Naccache L, Sourdet S, Cariou E, Fournier P, Nourhashemi F, Balardy L, Toulza O, Lairez O, Steinmeyer Z, et al. Frailty in Older Patients with Transthyretin Cardiac Amyloidosis. Journal of Clinical Medicine. 2023; 12(24):7507. https://doi.org/10.3390/jcm12247507

Chicago/Turabian Style

Cazalbou, Stéphanie, Louise Naccache, Sandrine Sourdet, Eve Cariou, Pauline Fournier, Fati Nourhashemi, Laurent Balardy, Olivier Toulza, Olivier Lairez, Zara Steinmeyer, and et al. 2023. "Frailty in Older Patients with Transthyretin Cardiac Amyloidosis" Journal of Clinical Medicine 12, no. 24: 7507. https://doi.org/10.3390/jcm12247507

APA Style

Cazalbou, S., Naccache, L., Sourdet, S., Cariou, E., Fournier, P., Nourhashemi, F., Balardy, L., Toulza, O., Lairez, O., Steinmeyer, Z., & on behalf of the Toulouse Amyloidosis Research Network. (2023). Frailty in Older Patients with Transthyretin Cardiac Amyloidosis. Journal of Clinical Medicine, 12(24), 7507. https://doi.org/10.3390/jcm12247507

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