Published online Mar 26, 2021. doi: 10.4330/wjc.v13.i3.55
Peer-review started: December 25, 2020
First decision: January 11, 2021
Revised: January 19, 2021
Accepted: February 11, 2021
Article in press: February 11, 2021
Published online: March 26, 2021
In transthyretin cardiac amyloidosis (ATTR), protein deposition leads to myocardial thickening and heart failure, which is defined as ATTR cardiomyopathy (ATTR-CM). Recently, evidence was raised that inflammation might be associated with disease progression in ATTR polyneuropathy and heart failure. But until now little is known about the inflammatory state in ATTR-CM. Therefore, we measured IL-6 levels in ATTR-CM and analyzed its predictive value for cardiac outcome.
In ATTR-CM stable disease over several years as well as rapidly progressive disease courses are described. This discrepancy might results from differences in immunological response to myocardial protein deposits in ATTR-CM.
The objective of the study was to investigate differences in IL-6 levels and evaluate its predictive value for cardiovascular outcome (death/heart transplantation, decom-pensation or a combined endpoint).
In this monocentric prospective study, 106 ATTR-CM patients were included, and IL-6 levels were measured using Luminex technology. Follow-up period was 12 mo, and statistical analysis was performed using parametric survival regression models.
IL-6 is associated with outcome in ATTR-CM but does not improve risk stratification in addition to established risk prediction parameters. The study thereby provides evidence that IL-6 axis might be involved in the pathogenesis of ATTR-CM. To investigate this hypothesis further, additional studies are needed.
The study showed that IL-6 is associated with outcome in ATTR-CM but does not add further risk stratification potential to established risk prediction models.
Further studies are needed to investigate inflammatory response in ATTR-CM.