Elevated interleukin-6 levels are associated with impaired outcome in cardiac transthyretin amyloidosis

Table 1 Patient characteristics

Study population, n = 148	Asympt ATTRv, n = 15	ATTRv, n = 52	Ctrl, n = 27	ATTRwt, n = 54	P value
Age (yr)	46.9 ± 11.2	66.1 ± 8.1	53.3 ± 19.6	78.5 ± 6.8	< 0.001
Sex, n (%)
Male	9 (60.0)	39 (75.0)	16 (59.3)	49 (90.7)	< 0.001
Female	6 (40.0)	13 (25.0)	11 (40.7)	5 (9.3 )
BMI	27.3 ± 5.6	26.1 ± 4.9	26.0 ± 5.5	25.5 ± 3.0	0.59
Medication, n (%)
Tafamidis	0 (0)	25 (48.1)	0 (0)	1 (1.9)	< 0.001
Beta blocker	2 (13.3)	20 (38.5)	7 (25.9)	41 (75.9)	< 0.001
ACE inhibitors/AT1 antagonists	3 (25.0)	16 (30.8)	7 (25.9)	37 (68.5)	< 0.001
Diuretics	2 (13.3)	27 (51.9)	4 (14.8)	52 (96.3)	< 0.001
Other antihypertensive medication (amlodipin, doxacor, nitrendipin)	2 (13.3)	1 (1.9)	0 (0)	7 (13.0)	0.10
Functional impairment
Karnofsky performance index, n (%)					< 0.001
≥ 80	15 (100)	39 (75.0)	27 (100)	45 (83.3)
< 80	0 (0.0)	13 (25.0)	0 (0 )	9 (16.7)
NYHA class, n (%)					< 0.001
I	15 (100)	23 (44.2)	23 (85.2)	7 (12.9)
II	0 (0.0)	15 (28.8)	3 (11.1)	16 (29.6)
III/IV	0 (0.0)	14 (26.9)	1 (3.7)	31 (57.4)
Risk classification, n (%)
Gillmore					< 0.001
I	15 (100)	30 (57.7)		16 (29.6)
II	0 (0.0)	14 (26.9)		26 (48.1)
III	0 (0.0)	8 (15.4)		12 (22.2)
Medical history, n (%)
Pacemaker implantation	0 (0.0)	10 (19.2)	1 (3.7)	13(24.0)	0.03
Diabetes mellitus	0 (0.0)	3 (5.7)	0 (0 )	9 (16.7)	0.02
Atrial fibrillation	1 (6.7)	16 (30.8)	3 (11.1)	35 (64.8)	< 0.001
ECG findings
Number of bundle branch blocks	0.14 ± 0.36	0.70 ± 0.85	0.19 ± 0.49	1.1 ± 0.8	< 0.001
Sinus rhythm, n (%)	14 (93.3)	37 (71.2)	24 (88.9)	26 (48.1)	< 0.001
Pace maker rhythm, n (%)	0 (0.0)	4 (7.7)	0 (0)	7 (13.0)	0.11
Low voltage pattern, n (%)	2 (13.3)	9 (17.3)	0 (0)	8 (14.8)	0.18
Heart frequency (bpm)	68.8 ± 14.3	74.2 ± 14.5	69.4 ± 10.6	79.6 ± 13.9	0.006
PQ interval (ms)	142.1 ± 30.1	176.8 ± 39.2	158.3 ± 25.6	210.3 ± 41.9	< 0.001
QRS time (ms)	99.8 ± 16.6	112.7 ± 30.2	97.3 ± 11.4	128.0 ± 33.3	< 0.001
QTc duration (ms)	402.4 ± 15.9	432.8 ± 42.4	400.6 ± 12.5	445.7 ± 32.5	< 0.001
Echocardiography
Posterior wall (mm)	9.5 ± 1.9	14.0 ± 0.5	10.0 ± 0.3	15.4 ± 3.2	< 0.001
IVS (mm)	10.9 ± 1.9	17.0 ± 0.7	11.0 ± 0.3	19.2 ± 3.9	< 0.001
Ejection fraction (%)	58.7 ± 2.2	52.5 ± 1.4	60.0 ± 1.9	44.3 ± 11.3	< 0.001
Diastolic dysfunction, n (%)	3 (20.0)	40 (76.9)	4 (14.8)	49 (90.7)	< 0.001
Global longitudinal strain	-14.6 ± 14.2	-12.0 ± 0.7		-9.8 ± 4.0	< 0.001
MAPSE (mm)	1.5 ± 0.3	1.1 ± 0.3	1.6 ± 0.09	0.9 ± 0.3	0.09
TAPSE (mm)	2.3 ± 0.4	1.8 ± 0.2	2.1 ± 0.1	1.5 ± 0.6	0.02
Pericardial effusion, n (%)	0 (0.0)	3 (5.8)	0 (0)	6 (11.1)	0.31
PA pressure (mmHg)	26.0 ± 4.1	31.0 ± 1.0	25.0 ± 1.3	35.8 ± 9.8	0.005
Biomarkers
NtproBNP(ng/L)	173.6 ± 260.6	3457.3 ± 4321.9	258.8 ± 35.2	7219.4 ± 8213.5	< 0.001
hsTNT (pg/mL)	4.7 ± 2.4	59.0 ± 95.4	8.1 ± 7.6	63.6 ± 40.7	< 0.001
GFR (mL/min)	101.1 ± 14.6	75.9 ± 24.9	96.3 ± 22.1	55.8 ± 18.6	< 0.001

ACE: Angiotensin converting enzyme; AT1: Angiotensin type 1; ATTRv: Variant transthyretin amyloidosis; ATTRwt: Wild-type transthyretin amyloidosis; BMI: Body mass index; NtproBNP: N-terminal pro-brain natriuretic peptide; ECG: Electrocardiogram; GFR: Glomerular filtration rate; IVS: Intravenous sedation; MAPSE: Mitral annular plane systolic excursion; NYHA: New York Heart Association; TAPSE: Tricuspid annular plane systolic excursion; TNT: TroponinT.