2025/11/01 by Chunxiao Su, Yongzhi Cai, Tongtong Huang +7
paper · doi:10.1111/echo.70343
ABSTRACT Background Light chain cardiac amyloidosis (AL‐CA) is an infiltrative cardiomyopathy characterized by the deposition of abnormally folded proteins in the myocardium and atrial walls. This study aims to evaluate right atrial (RA) stiffness—defined as the ratio of tricuspid E/e’ (reflecting right ventricular diastolic function) to RA reservoir strain (right atrial reservoir strain (RASr), reflecting RA mechanical properties)—using speckle‐tracking echocardiography, predicting the primary outcome in AL‐CA, and assessing its incremental predictive value. Methods Seventy‐eight patients (age: 59.40 ± 8.92 years; 60.3% male) with AL‐CA and available follow‐up data were studied by biopsy, noncardiac biopsy with supportive cardiac imaging. Clinical and routine echocardiographic data were retrospectively analyzed, with all‐cause mortality followed during the period from September 2021 to September 2024. Results The median follow‐up duration was 736 days (interquartile range: 375–1096 days). All‐cause mortality occurred in 28 patients (36%). Restricted cubic spline (RCS) analysis identified a RA stiffness threshold of 0.9 as a robust outcome predictor ( p Tricuspid E/e’/RASr ) was independently associated with adverse outcomes (adjusted hazard ratio = 4.33, p p Conclusion RA stiffness evaluated by speckle‐tracking echocardiography has prognostic value in AL‐CA, adding incremental predictive value to conventional staging models.