Prognostic Implications of Echocardiographic Parameters in Patients with Transthyretin Cardiac Amyloidosis on Tafamidis

Authors

• Mitchell Sarkisov, Corewell Health West Resident
• Mohammad Ahmed, Corewell Health West Fellow
• Paul Weber, Corewell Health West Resident
• Connor C. Kerndt, Corewell Health West Fellow
• Nabin Manandhar Shrestha, Corewell Health West
• Stephen Orey, Corewell Health West
• David R. Fermin, Corewell Health West
• Matthew Gonzalez, Corewell Health West

Document Type

Conference Proceeding

Publication Date

4-2026

Publication Title

Journal of the American College of Cardiology

Abstract

Background: Tafamidis improves outcomes for ATTR cardiac amyloidosis (ATTR-CA). The prognostic significance of diastology and filling pressures in patients on tafamidis is not well known.

Methods: Patients with ATTR-CA who underwent transthoracic echocardiography (TTE) within 6 months of tafamidis initiation were retrospectively analyzed. Four groups were analyzed based on: diastology (Group 1), right atrial pressure (RAP; Group 2), wedge pressure (PCWP; Group 3), and bilateral pressures (Group 4). Outcomes of hospitalizations and mortality were assessed.

Results: 177 patients underwent TTE within 6 months of tafamidis initiation. In Group 1, patients with abnormal diastology were more likely to have lower left ventricular function and elevated PCWP with no differences in outcomes. In Group 2, patients with elevated RAP were more likely to have atrial enlargement and higher pulmonary pressures with no differences in outcomes. In Group 3, patients with elevated PCWP were more likely to be hospitalized at 1 year, experience mortality, and experience death due to end stage heart failure. In Group 4, patients with elevated bilateral pressures had a higher likelihood of death due to end stage heart failure with a trend towards increased all-cause mortality.

Conclusion: Despite the mortality benefit of tafamidis in ATTR-CA, elevated PCWP and bilateral pressures may be associated with worse outcomes. Further studies are needed to evaluate the utility of cardiac imaging to identify high-risk phenotypes.

Volume

87

Issue

13 Suppl

First Page

A621

Comments

American College of Cardiology 75th Annual Scientific Session & Expo, March 28-30, 2026, New Orleans, LA

Last Page

A621

Recommended Citation

Sarkisov M, Ahmed M, Weber P, Kerndt CC, Shrestha NM, Orey S, et al. [Fermin DR, Gonzalez M]. Prognostic implications of echocardiographic parameters in patients with transthyretin cardiac amyloidosis on tafamidis. J Am Coll Cardiol. 2026;87(13 Suppl):A621. doi:10.1016/j.jacc.2026.02.1644.

DOI

10.1016/j.jacc.2026.02.1644

ISSN

0735-1097