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  1. Article: Les amyloses cardiaques.

    Poullot, Elsa / Oghina, Silvia / Kalsoum, Sarah / Damy, Thibaud

    Annales de pathologie

    2021  Volume 41, Issue 1, Page(s) 25–37

    Abstract: Different types of amyloid deposits involve the heart. Transthyretin and light chain amyloidosis are the most frequent. Diagnostic performance, typing and treatments have improved in the last decade, and prognosis of cardiac amyloidosis is now ... ...

    Title translation Cardiac amyloidosis.
    Abstract Different types of amyloid deposits involve the heart. Transthyretin and light chain amyloidosis are the most frequent. Diagnostic performance, typing and treatments have improved in the last decade, and prognosis of cardiac amyloidosis is now significantly better thanks to targeted therapies. In this article, we will describe the clinical manifestations of cardiac amyloidosis, the diagnostic approach and detail the characteristics and specific treatments of the most frequent types of cardiac amyloidosis. We will focus on the histopathological aspects, especially on the importance of amyloid typing.
    MeSH term(s) Amyloid ; Amyloidosis/diagnosis ; Humans ; Prognosis
    Chemical Substances Amyloid
    Language French
    Publishing date 2021-01-06
    Publishing country France
    Document type Journal Article
    ZDB-ID 225720-8
    ISSN 0242-6498
    ISSN 0242-6498
    DOI 10.1016/j.annpat.2020.11.010
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  2. Article ; Online: Les amyloses cardiaques : état des lieux en 2022.

    Oghina, S / Delbarre, M A / Poullot, E / Belhadj, K / Fanen, P / Damy, T

    La Revue de medecine interne

    2022  Volume 43, Issue 9, Page(s) 537–544

    Abstract: The 3 main types of cardiac amyloidosis are linked to two protein precursors: AL amyloidosis secondary to free light chain deposits in the context of monoclonal gammopathy (mainly of undetermined significance or myeloma) and transthyretin amyloidosis ( ... ...

    Title translation Cardiac amyloidosis: State of art in 2022.
    Abstract The 3 main types of cardiac amyloidosis are linked to two protein precursors: AL amyloidosis secondary to free light chain deposits in the context of monoclonal gammopathy (mainly of undetermined significance or myeloma) and transthyretin amyloidosis (ATTR), comprising wild-type transthyretin amyloidosis (ATTRwt for wild type) and hereditary transthyretin amyloidosis (ATTRv for variant). These diseases are underdiagnosed and highly prevalent in common cardiac phenotypes in recent studies (heart failure with preserved ejection fraction, severe aortic stenosis, hypertrophic cardiomyopathy). Myocardial amyloid infiltration affects all cardiac structures and clinically promotes predominantly heart failure, conductive disorders and cardioembolic events. The search for extracardiac signs makes it possible to arouse diagnostic suspicion. Electrocardiogram, echocardiography and cardiac MRI can suspect cardiac amyloidosis. The diagnostic confirmation follows a simple algorithm including a systematic search for monoclonal gammapathy and a disphosphonate scintigraphy. Histological proof is necessary in case of AL or ATTR amyloidosis with concomitant monoclonal gammopathy in order to initiate specific treatment. Due to the late disease onset in ATTRv, genetic testing must be routine in all cases of ATTR. These diseases are no longer perceived as incurable since recent therapeutic innovations. A better knowledge of the disease is more than ever necessary.
    MeSH term(s) Amyloid Neuropathies, Familial/complications ; Amyloid Neuropathies, Familial/diagnosis ; Amyloid Neuropathies, Familial/therapy ; Cardiomyopathies/diagnosis ; Heart Failure ; Humans ; Immunoglobulin Light-chain Amyloidosis/diagnosis ; Monoclonal Gammopathy of Undetermined Significance
    Language French
    Publishing date 2022-07-21
    Publishing country France
    Document type Journal Article ; Review
    ZDB-ID 604679-4
    ISSN 1768-3122 ; 0248-8663
    ISSN (online) 1768-3122
    ISSN 0248-8663
    DOI 10.1016/j.revmed.2022.04.036
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  3. Article ; Online: Identification of an EML4-ALK rearrangement in an intrahepatic cholangiocarcinoma.

    Favre, Loëtitia / Pujals, Anaïs / Maille, Pascale / Poullot, Elsa / Calderaro, Julien

    Pathology international

    2021  Volume 71, Issue 9, Page(s) 630–632

    MeSH term(s) Aged ; Cholangiocarcinoma/diagnosis ; Cholangiocarcinoma/genetics ; Cholangiocarcinoma/pathology ; Cholangiocarcinoma/surgery ; Gene Rearrangement ; Hepatectomy ; Humans ; In Situ Hybridization, Fluorescence ; Liver/pathology ; Liver/surgery ; Liver Neoplasms/diagnosis ; Liver Neoplasms/genetics ; Liver Neoplasms/pathology ; Liver Neoplasms/surgery ; Male ; Oncogene Proteins, Fusion/genetics
    Chemical Substances EML4-ALK fusion protein, human ; Oncogene Proteins, Fusion
    Language English
    Publishing date 2021-07-07
    Publishing country Australia
    Document type Case Reports ; Letter
    ZDB-ID 1194850-4
    ISSN 1440-1827 ; 1320-5463
    ISSN (online) 1440-1827
    ISSN 1320-5463
    DOI 10.1111/pin.13138
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  4. Article ; Online: Comparison of cardiac involvement, extracardiac manifestations and outcomes between homozygote and heterozygote transthyretin p.Val142Ile (V122I) variant in patients with hereditary transthyretin amyloidosis: a cohort study.

    Albenque, Grégoire / Bézard, Mélanie / Kharoubi, Mounira / Odouard, Shirley / Lunati, Ariane / Poullot, Elsa / Zaroui, Amira / Teiger, Emmanuel / Hittinger, Luc / Audard, Vincent / El Karoui, Khalil / Funalot, Benoît / Fanen, Pascale / Damy, Thibaud / Oghina, Silvia

    Amyloid : the international journal of experimental and clinical investigation : the official journal of the International Society of Amyloidosis

    2023  Volume 30, Issue 4, Page(s) 407–415

    Abstract: Background: Hereditary transthyretin (ATTRv) p.Val142Ile (V122I) mutation is the most common inherited cause of cardiac amyloidosis and little is known about the phenotype and outcome of the rare homozygotic genotype. This study aimed to compare ... ...

    Abstract Background: Hereditary transthyretin (ATTRv) p.Val142Ile (V122I) mutation is the most common inherited cause of cardiac amyloidosis and little is known about the phenotype and outcome of the rare homozygotic genotype. This study aimed to compare phenotypic characteristics and outcomes between heterozygous and homozygous patients with ATTRv V122I amyloidosis.
    Material and methods: This monocentric, observational, retrospective study conducted at the French National Referral Centre for Cardiac Amyloidosis (Henri Mondor Hospital, Créteil), described clinical, electrocardiographic, cardiac imaging features and prognostic data for patients with ATTRv V122I amyloidosis.
    Results: Among 185 ATTRv V122I patients identified, 161 were heterozygous and 24 were homozygous. The homozygous frequency was 13%. Onset occured significantly earlier in the homozygotes compared to heterozygotes with earlier median age at diagnosis (67[63-71] years vs 76[70-79] years,
    Conclusion: This rare, homozygous V122I cohort confirmed the earlier age of onset, death and cardiac events in this population.
    MeSH term(s) Humans ; Middle Aged ; Aged ; Cohort Studies ; Homozygote ; Heterozygote ; Retrospective Studies ; Prealbumin/genetics ; Amyloid Neuropathies, Familial/genetics ; Amyloid Neuropathies, Familial/complications
    Chemical Substances Prealbumin
    Language English
    Publishing date 2023-06-28
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 1205246-2
    ISSN 1744-2818 ; 1350-6129
    ISSN (online) 1744-2818
    ISSN 1350-6129
    DOI 10.1080/13506129.2023.2227322
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  5. Article ; Online: Prognostic mortality factors in advanced light chain cardiac amyloidosis: A prospective cohort study.

    Zaroui, Amira / Kharoubi, Mounira / Gounot, Romain / Oghina, Silvia / Degoutte, Charlotte / Bezard, Melanie / Galat, Arnault / Guendouz, Soulef / Roulin, Louise / Audard, Vincent / Leroy, Vincent / Teiger, Emmanuel / Poullot, Elsa / Molinier-Frenkel, Valérie / Le Bras, Fabien / Belhadj, Karim / Bastard, Jean-Philippe / Fellahi, Soraya / Shourick, Jason /
    Lemonier, Francois / Damy, Thibaud

    ESC heart failure

    2024  

    Abstract: Aims: Predicting mortality in severe AL cardiac amyloidosis is challenging due to elevated biomarker levels and limited thresholds for stratifying severe cardiac damage.: Methods and results: This prospective, observational, cohort study included de ... ...

    Abstract Aims: Predicting mortality in severe AL cardiac amyloidosis is challenging due to elevated biomarker levels and limited thresholds for stratifying severe cardiac damage.
    Methods and results: This prospective, observational, cohort study included de novo, confirmed cardiac AL amyloidosis patients at the Henri Mondor National Reference Centre. The goal was to identify predictors of mortality to enhance prognostic stratification and improve informed decision-making regarding therapy. Over the 12-year study period, among the 233 patients included, 133 were NYHA III-IV and 179 Mayo 2004 III. The independent predictors for mortality identified were hsTnT, NT-proBNP, cardiac output, and conjugated bilirubin. A novel prognostic, conditional stratification, Mondor amyloidosis cardiac staging (MACS) was developed with biomarker cut-off values for Stage 1: hsTnT ≤ 107 ng/L and NT-proBNP ≤ 3867 ng/L (n = 77; 33%); for stage 2 NT-proBNP > 3867 ng/L (n = 72; 30%). For stage 3, if troponin >107 ng/L, regardless of NT-proBNP then CB 4 μmol/L, was added (n = 41; 17.5%) and stage 4: CB > 4 μmol/L (n = 43; 18.5%). The median overall survival was 8 months 95% CI [2-24]. At 1 year, 102 (44%) patients died and the Kaplan-Meier median survival with MACS Stage 1 was not reached, while stage 2 was 15.2 months (95% CI [11-18]) and stage 3, 6.6 months (95% CI [1-13]). Notably, among European stage II patients, 17.1%, n = 8 were MACS stage 3 and European stage IIIb 21.4% (n = 23) were MACS stage 4. Importantly, among European stage IIIb patients 42.2% (n = 29) were classified MACS stage 4 and 12.5% n = 9 were only MACS stage 2.
    Conclusions: The Mondor prognostic staging system, including conjugate bilirubin may significantly improve prognostic stratification for patients with severe cardiac amyloidosis.
    Language English
    Publishing date 2024-03-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 2814355-3
    ISSN 2055-5822 ; 2055-5822
    ISSN (online) 2055-5822
    ISSN 2055-5822
    DOI 10.1002/ehf2.14671
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  6. Article ; Online: Baseline circulating tumour DNA and total metabolic tumour volume as early outcome predictors in aggressive large B-cell lymphoma. A real-world 112-patient cohort.

    Le Goff, Enora / Blanc-Durand, Paul / Roulin, Louise / Lafont, Charlotte / Loyaux, Romain / MBoumbae, Diana-Laure / Benmaad, Ichrafe / Claudel, Alexis / Poullot, Elsa / Robe, Cyrielle / Gricourt, Guillaume / Aissat, Abdelrazak / Copie-Bergman, Christiane / Lemonnier, François / Gaulard, Philippe / Itti, Emmanuel / Haioun, Corinne / Delfau-Larue, Marie-Helene

    British journal of haematology

    2023  Volume 202, Issue 1, Page(s) 54–64

    Abstract: Approximately 20%-50% of patients with large B-cell lymphoma (LBCL) experience poor outcomes. We aimed to evaluate the combined prognostic value of circulating tumour DNA (ctDNA) and total metabolic tumour volume (TMTV) in LBCL. This observational single- ...

    Abstract Approximately 20%-50% of patients with large B-cell lymphoma (LBCL) experience poor outcomes. We aimed to evaluate the combined prognostic value of circulating tumour DNA (ctDNA) and total metabolic tumour volume (TMTV) in LBCL. This observational single-centre study included 112 newly diagnosed LBCL patients, receiving R-CHOP/R-CHOP-like chemotherapies. CtDNA load was calculated following next-generation sequencing of cell-free DNA (cfDNA) using a targeted 40-gene lymphopanel. TMTV was measured using a fully automated artificial intelligence-based method for lymphoma lesion segmentation. CtDNA was detected in cfDNA samples from 95 patients with a median concentration of 3.15 log haploid genome equivalents per mL. TMTV measurements were available for 102 patients. The median TMTV was 501 mL. High ctDNA load (>3.57 log hGE/mL) or high TMTV (>200 mL) were associated with shorter 1-year PFS (44% vs. 83%, p < 0.001 and 64% vs. 97%, p = 0.002, respectively). When combined, three prognostic groups were identified. The shortest PFS was observed when both TMTV and ctDNA load were high (p < 0.001). Even with a short follow up, combining ctDNA load with TMTV improved the risk stratification of patients with aggressive LBCL. In the near future, very high-risk patients could benefit from CAR T-cell therapy or bispecific antibodies as first-line treatments.
    MeSH term(s) Humans ; Circulating Tumor DNA/genetics ; Tumor Burden ; Artificial Intelligence ; Prognosis ; Lymphoma, Large B-Cell, Diffuse/genetics ; Lymphoma, Large B-Cell, Diffuse/therapy ; Lymphoma, Large B-Cell, Diffuse/diagnosis ; Fluorodeoxyglucose F18/therapeutic use ; Positron Emission Tomography Computed Tomography ; Retrospective Studies
    Chemical Substances Circulating Tumor DNA ; Fluorodeoxyglucose F18 (0Z5B2CJX4D)
    Language English
    Publishing date 2023-04-10
    Publishing country England
    Document type Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80077-6
    ISSN 1365-2141 ; 0007-1048
    ISSN (online) 1365-2141
    ISSN 0007-1048
    DOI 10.1111/bjh.18809
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  7. Article ; Online: Angioimmunoblastic T-cell lymphoma and Kaposi sarcoma: A fortuitous collision?

    Poullot, Elsa / Milowich, Dina / Lemonnier, François / Bisig, Bettina / Robe, Cyrielle / Pelletier, Laura / Letourneau, Audrey / Dupuy, Aurélie / Sako, Nouhoum / Ketterer, Nicolas / Carde, Patrice / Dartigues, Peggy / Delfau-Larue, Marie-Hélène / de Leval, Laurence / Gaulard, Philippe

    Histopathology

    2023  Volume 84, Issue 3, Page(s) 556–564

    Abstract: Aims: Follicular helper T-cell (TFH) lymphoma of the angioimmunoblastic-type (AITL), one of the most prevalent T-cell lymphomas, typically encompasses proliferation of high endothelial venules and Epstein-Barr virus-positive immunoblasts, but neither ... ...

    Abstract Aims: Follicular helper T-cell (TFH) lymphoma of the angioimmunoblastic-type (AITL), one of the most prevalent T-cell lymphomas, typically encompasses proliferation of high endothelial venules and Epstein-Barr virus-positive immunoblasts, but neither infection with HHV8 nor association with Kaposi's sarcoma (KS) have been described. The aims of this study are to characterise the association between AITL and HHV8 infection or KS.
    Methods and results: Three male patients aged 49-76 years, HIV-negative, with concurrent nodal involvement by AITL and KS, were identified from our files and carefully studied. Two patients originated from countries where endemic KS occurs, including one with cutaneous KS. The lymphomas featured abundant vessels, expanded follicular dendritic cells and neoplastic TFH cells [PD1+ (three of three), ICOS+ (three of three), CXCL13+ (three of three), CD10
    Conclusion: Concurrent nodal involvement by AITL and KS is rare and identification of both neoplastic components may pose diagnostic challenges. The question of whether the association between AITL and KS may be fortuitous or could reflect the underlying immune dysfunction in AITL remains open.
    MeSH term(s) Humans ; Male ; Sarcoma, Kaposi ; Epstein-Barr Virus Infections ; Herpesvirus 4, Human ; Neoplasm Recurrence, Local ; Immunoblastic Lymphadenopathy/complications ; Immunoblastic Lymphadenopathy/genetics ; Lymphoma, T-Cell/pathology ; Lymphoma, T-Cell, Peripheral/complications ; Lymphoma, T-Cell, Peripheral/diagnosis
    Language English
    Publishing date 2023-11-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 131914-0
    ISSN 1365-2559 ; 0309-0167
    ISSN (online) 1365-2559
    ISSN 0309-0167
    DOI 10.1111/his.15083
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  8. Article ; Online: ALK+ large B cell lymphoma presenting as multiple bowel-obstructing, cytokeratin-positive tumours.

    Petronilho, Sara / Gournay, Viviane / Tauziede-Espariat, Arnault / Pina, Héloïse / Pecriaux, Adrien / Drieux, Fanny / Poullot, Elsa / Briere, Josette / Lechapt, Emmanuèle / Gaulard, Phillippe

    Histopathology

    2022  Volume 80, Issue 7, Page(s) 1128–1130

    MeSH term(s) Humans ; Keratins ; Ki-1 Antigen ; Lymphoma, Large B-Cell, Diffuse/diagnosis ; Lymphoma, Large B-Cell, Diffuse/pathology ; Lymphoma, Large-Cell, Anaplastic/pathology ; Receptor Protein-Tyrosine Kinases
    Chemical Substances Ki-1 Antigen ; Keratins (68238-35-7) ; Receptor Protein-Tyrosine Kinases (EC 2.7.10.1)
    Language English
    Publishing date 2022-03-17
    Publishing country England
    Document type Journal Article
    ZDB-ID 131914-0
    ISSN 1365-2559 ; 0309-0167
    ISSN (online) 1365-2559
    ISSN 0309-0167
    DOI 10.1111/his.14635
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  9. Article ; Online: A Comprehensive Clinicopathologic and Molecular Study of 19 Primary Effusion Lymphomas in HIV-infected Patients.

    Calvani, Julien / Gérard, Laurence / Fadlallah, Jehane / Poullot, Elsa / Galicier, Lionel / Robe, Cyrielle / Garzaro, Margaux / Bertinchamp, Remi / Boutboul, David / Cuccuini, Wendy / Cayuela, Jean-Michel / Gaulard, Philippe / Oksenhendler, Éric / Meignin, Véronique

    The American journal of surgical pathology

    2021  Volume 46, Issue 3, Page(s) 353–362

    Abstract: Primary effusion lymphoma (PEL) is associated with human herpesvirus 8 and frequently with Epstein-Barr virus (EBV). We report here a single-center series of 19 human immunodeficiency virus-associated PELs, including 14 EBV+ and 5 EBV- PELs. The ... ...

    Abstract Primary effusion lymphoma (PEL) is associated with human herpesvirus 8 and frequently with Epstein-Barr virus (EBV). We report here a single-center series of 19 human immunodeficiency virus-associated PELs, including 14 EBV+ and 5 EBV- PELs. The objectives were to describe the clinicopathologic features of PELs, with a focus on programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) expression, to search for genetic alterations by targeted deep sequencing analysis, and to compare the features between EBV+ and EBV- cases. All the patients were male, and the median age at diagnosis was 47 years old (interquartile range: 40 to 56 y). Reflecting the terminal B-cell differentiation, immunophenotypic profiles showed low expression levels of B-cell markers, including CD19 (0/19), CD20 (1/19), CD79a (0/19), PAX5 (1/19), BOB1 (3/19), and OCT2 (4/19), contrasting with a common expression of CD38 (10/19), CD138 (7/19), and IRF4/MUM1 (18/19). We observed a frequent aberrant expression of T-cell markers, especially CD3 (10/19), and less frequently CD2 (2/19), CD4 (3/19), CD5 (1/19), and CD8 (0/19). Only 2 cases were PD-L1 positive on tumor cells and none PD-1 positive. With respect to immune cells, 3 samples tested positive for PD-L1 and 5 for PD-1. Our 36-gene lymphopanel revealed 7 distinct variants in 5/10 PELs, with either a single or 2 mutations per sample: B2M (n=2), CD58 (n=1), EP300 (n=1), TNFAIP3 (n=1), ARID1A (n=1), and TP53 (n=1). Finally, we did not observe any major clinical, pathologic, or immunohistochemical differences between EBV+ and EBV- PELs and the outcome was similar (2-y overall survival probability of 61.9% [95% confidence interval, 31.2-82.1] vs. 60.0% [95% confidence interval, 12.6-88.2], respectively, P=0.62).
    MeSH term(s) Adult ; Biomarkers, Tumor/metabolism ; HIV Infections/complications ; Humans ; Immunohistochemistry ; Lymphoma, Primary Effusion/diagnosis ; Lymphoma, Primary Effusion/metabolism ; Lymphoma, Primary Effusion/pathology ; Lymphoma, Primary Effusion/virology ; Male ; Middle Aged
    Chemical Substances Biomarkers, Tumor
    Language English
    Publishing date 2021-09-22
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 752964-8
    ISSN 1532-0979 ; 0147-5185
    ISSN (online) 1532-0979
    ISSN 0147-5185
    DOI 10.1097/PAS.0000000000001813
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  10. Article ; Online: Assessing Cardiac Amyloidosis Subtypes by Unsupervised Phenotype Clustering Analysis.

    Bonnefous, Louis / Kharoubi, Mounira / Bézard, Mélanie / Oghina, Silvia / Le Bras, Fabien / Poullot, Elsa / Molinier-Frenkel, Valérie / Fanen, Pascale / Deux, Jean-François / Audard, Vincent / Itti, Emmanuel / Damy, Thibaud / Audureau, Etienne

    Journal of the American College of Cardiology

    2021  Volume 78, Issue 22, Page(s) 2177–2192

    Abstract: Background: Cardiac amyloidosis (CA) is a set of amyloid diseases with usually predominant cardiac symptoms, including light-chain amyloidosis (AL), hereditary variant transthyretin amyloidosis (ATTRv), and wild-type transthyretin amyloidosis (ATTRwt). ... ...

    Abstract Background: Cardiac amyloidosis (CA) is a set of amyloid diseases with usually predominant cardiac symptoms, including light-chain amyloidosis (AL), hereditary variant transthyretin amyloidosis (ATTRv), and wild-type transthyretin amyloidosis (ATTRwt). CA are characterized by high heterogeneity in phenotypes leading to diagnosis delay and worsened outcomes.
    Objectives: The authors used clustering analysis to identify typical clinical profiles in a large population of patients with suspected CA.
    Methods: Data were collected from the French Referral Center for Cardiac Amyloidosis database (Hôpital Henri Mondor, Créteil), including 1,394 patients with suspected CA between 2010 and 2018: 345 (25%) had a diagnosis of AL, 263 (19%) ATTRv, 402 (29%) ATTRwt, and 384 (28%) no amyloidosis. Based on comprehensive clinicobiological phenotyping, unsupervised clustering analyses were performed by artificial neural network-based self-organizing maps to identify patient profiles (clusters) with similar characteristics, independent of the final diagnosis and prognosis.
    Results: Mean age and left ventricular ejection fraction were 72 ± 13 years and 52% ± 13%, respectively. The authors identified 7 clusters of patients with contrasting profiles and prognosis. AL patients were distinctively located within a typical cluster; ATTRv patients were distributed across 4 clusters with varying clinical presentations, 1 of which overlapped with patients without amyloidosis; interestingly, ATTRwt patients spread across 3 distinct clusters with contrasting risk factors, biological profiles, and prognosis.
    Conclusions: Clustering analysis identified 7 clinical profiles with varying characteristics, prognosis, and associations with diagnosis. Especially in patients with ATTRwt, these results suggest key areas to improve amyloidosis diagnosis and stratify prognosis depending on associated risk factors.
    MeSH term(s) Aged ; Aged, 80 and over ; Amyloidosis/classification ; Amyloidosis/diagnosis ; Amyloidosis/physiopathology ; Cardiomyopathies/classification ; Cardiomyopathies/diagnosis ; Cardiomyopathies/physiopathology ; Cluster Analysis ; Disease Progression ; Echocardiography/methods ; Female ; Follow-Up Studies ; Humans ; Male ; Phenotype ; Prognosis ; Prospective Studies ; Stroke Volume/physiology ; Time Factors ; Ventricular Function, Left/physiology
    Language English
    Publishing date 2021-11-22
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 605507-2
    ISSN 1558-3597 ; 0735-1097
    ISSN (online) 1558-3597
    ISSN 0735-1097
    DOI 10.1016/j.jacc.2021.09.858
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