Abstract

Reduced exercise tolerance is one of the hallmarks of patients with cardiac amyloidosis (CA), but detailed biological responses during exercise were not investigated. The purpose of this study was to compare the cardiopulmonary exercise test (CPX) parameters between CA patients and propensity-matched heart failure patients. This was a single-center, retrospective, observational study of patients diagnosed with CA. The control group was extracted by propensity score matching from patients who underwent CPX for chronic heart failure during the same period. Clinical data including assessment of biological responses during CPX were compared between the patients with CA (CA group, n = 16) and the control group (non-CA group, n = 16). Echocardiography suggested more impaired diastolic function in the CA group than in the non-CA group. There was no significant difference between groups in the fraction of end-tidal carbon dioxide (FETCO₂) at rest. However, the difference between the FETCO₂ at rest and the FETCO₂ at the respiratory compensation point (ΔFETCO₂) was significantly smaller in the CA group than in the non-CA group (0.40% ± 0.37% vs. 0.82% ± 0.33%; p = 0.002). Only in the CA group, there was a significant negative correlation between the ΔFETCO₂ and the E/e’ ratio on echocardiography (r = − 0.521; p = 0.039) and the serum high-sensitivity troponin T concentration (r = − 0.501; p = 0.048). In conclusion, patients with CA may find it difficult to increase cardiac output during exercise due to severe diastolic dysfunction.

中文翻译：

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心脏淀粉样变性患者运动时呼气末二氧化碳浓度升高减弱

摘要

运动耐量降低是心脏淀粉样变性 (CA) 患者的标志之一，但尚未研究运动期间的详细生物反应。本研究的目的是比较 CA 患者和倾向匹配心力衰竭患者的心肺运动试验 (CPX) 参数。这是一项针对诊断患有 CA 的患者的单中心、回顾性、观察性研究。对照组通过倾向评分匹配从同期因慢性心力衰竭接受CPX的患者中提取。比较CA患者（CA组，n = 16）和对照组（非CA组）的临床数据，包括CPX期间生物反应评估组，n = 16)。超声心动图显示，CA 组的舒张功能受损程度高于非 CA 组。静息时潮气末二氧化碳分数 (FETCO₂) 组间没有显着差异。但是，静止状态下的 FETCO₂ 与 FETCO₂ 之间存在差异CA组呼吸代偿点的ΔFETCO₂明显小于非CA组（0.40% ± 0.37% vs. 0.82） % ± 0.33%；p = 0.002）。仅在CA组中，ΔFETCO₂与超声心动图E/e'比值之间存在显着负相关（r = − 0.521; p = 0.039）和血清高敏肌钙蛋白T浓度（< /span> = 0.048）。总之，CA患者可能会因严重的舒张功能障碍而难以在运动时增加心输出量。p = − 0.501；r