Prevalence of Orthopedic Manifestations in Patients With Cardiac Amyloidosis With a Focus on Shoulder Pathologies.
Prevalence of Orthopedic Manifestations in Patients With Cardiac Amyloidosis With a Focus on Shoulder Pathologies.
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心脏淀粉样变性患者骨科表现的患病率，重点是肩部病理。
DOI：
10.1016/j.amjcard.2022.11.014
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Hanna,Mazen
中科院分区：
文献类型：
--
作者：
Basdavanos,Alyssa;Maurer,MathewS;Ives,Lauren;Derwin,Kathleen;Ricchetti,EricT;Seitz,William;Hanna,Mazen
经甲状腺激素心脏淀粉样变性(ATTR-CA)是一种限制性心肌病，在其出现在心脏之前，已与多种骨科病理有关。目前还没有关于心脏淀粉样变性(CA)患者的各种肩部病变的患病率的研究。由于转甲状腺素优先沉积在软组织和关节中，我们预测在ATTR-CA患者中肩部病理和其他骨科表现的患病率更高。这项单中心、回顾性、病例对照研究分析了1310名CA患者、830名ATTR-CA患者和480名轻链CA(AL-CA)患者。在肩、髋关节和膝关节置换术中，比较CA患者与年龄匹配的公开估计的普通人群中超过3亿患者的优势比。患者的第一次肩部病理(即肩关节置换)和他们被诊断为CA的年份之间的时间是使用已知手术日期的患者的数据来确定的。总体而言，与AL-CA患者相比，ATTR-CA患者表现出更多的肩部病变(p<；0.001)和至少1种骨科表现(p<；0.001)。60岁或以上的ATTR-CA和AL-CA患者接受肩关节置换术的几率分别是年龄匹配的对照组的6.05倍(95%可信区间4.26~8.60)和1.63倍(95%可信区间0.67~3.94)。肩部病理和伴随的骨科病理在ATTR-CA患者中很常见，可能有助于在疾病进展的早期识别CA患者，以便及早干预和治疗。
Transthyretin cardiac amyloidosis (ATTR-CA) is a restrictive cardiomyopathy that has been associated with multiple orthopedic pathologies years before it manifests in the heart. There have been no studies on the prevalence of a wide range of shoulder pathologies in patients with cardiac amyloidosis (CA). Due to the preferential deposition of transthyretin in the soft tissues and joints, we predicted a greater prevalence of shoulder pathologies and other orthopedic manifestations in patients with ATTR-CA. This single-center, retrospective, case-control study, analyzed 1,310 patients with CA, 830 with ATTR-CA, and 480 with light-chain CA (AL-CA) from a dedicated CA REDcap database. Odds ratios comparing patients with CA to the age-matched published estimate of over 300 million patients in the general population were determined for shoulder, hip, and knee arthroplasty. Years between a patient's first shoulder pathology (i.e., shoulder arthroplasty) and the year of their diagnosis with CA were determined using data from patients with a known date of surgery. Overall, patients with ATTR-CA compared with patients with AL-CA presented more frequently with shoulder pathologies (p <0.001) and at least 1 orthopedic manifestation (p <0.001). The odds of patients with ATTR-CA and AL-CA aged 60 years or older who underwent shoulder arthroplasty was 6.05 times greater (95% confidence interval 4.26 to 8.60) and 1.63 times greater (95% confidence interval 0.67 to 3.94), respectively, compared with age-matched controls. Shoulder pathologies and concomitant orthopedic pathologies are common in patients with ATTR-CA and may help identify patients with CA earlier in their disease progression for earlier intervention and treatment.
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影响因子：
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作者：
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DOI：
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发表时间：
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期刊：
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