The Prevalence of Advanced Interatrial Block and Its Relationship to Left Atrial Function in Patients with Transthyretin Cardiac Amyloidosis

• Main Authors: Thomas Lindow, Per Lindqvist
• Format: Article
• Language: English
• Published: MDPI AG 2021-06-01
• Series: Journal of Clinical Medicine
• Subjects: interatrial block; left atrial strain; cardiac amyloidosis; transthyretin amyloid
• Online Access: https://www.mdpi.com/2077-0383/10/13/2764

Background: Advanced interatrial block (aIAB), which is associated with incident atrial fibrillation and stroke, occurs in the setting of blocked interatrial conduction. Atrial amyloid deposition could be a possible substrate for reduced interatrial conduction, but the prevalence of aIAB in patients with transthyretin cardiac amyloidosis (ATTR-CA) is unknown. We aimed to describe the prevalence of aIAB and its relationship to left atrial function in patients with ATTR-CA in comparison to patients with HF and left ventricular hypertrophy but no CA. Methods: The presence of aIAB was investigated among 75 patients (49 patients with ATTR-CA and 26 with HF but no CA). A comprehensive echocardiographic investigation was performed in all patients, including left atrial strain and strain rate measurements. Results: Among patients with ATTR-CA, 27% had aIAB and in patients with HF but no CA, this figure was 21%, (<i>p</i> = 0.78). The presence of aIAB was associated with a low strain rate during atrial contraction (<0.91 s⁻¹) (OR: 5.2 (1.4–19.9)), even after adjusting for age and LAVi (OR: 4.5 (1.0–19.19)). Conclusions: Advanced interatrial block is common among patients with ATTR-CA, as well as in patients with heart failure and left ventricular hypertrophy but no CA. aIAB is associated with reduced left atrial contractile function.