Left atrial structure and function of the amyloidogenic V122I transthyretin variant in elderly African Americans

Masatoshi Minamisawa, Riccardo M. Inciardi, Brian Claggett, Sarah A.M. Cuddy, Candida C. Quarta, Amil M. Shah, Sharmila Dorbala, Rodney H. Falk, Kunihiro Matsushita, Dalane W. Kitzman, Lin Y. Chen, Scott D. Solomon

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


AIMS: African-American carriers of the transthyretin (TTR) valine-to-isoleucine substitution (V122I) are at increased risk of heart failure, yet many have relatively subtle abnormalities of left ventricular (LV) function. We sought to explore the influence of this mutation on left atrial (LA) structure and function in this population.

METHODS AND RESULTS: We assessed 1225 genotyped African-Americans (age range, 67-89 years) participating in the Atherosclerosis Risk in Communities study who underwent echocardiography and were in sinus rhythm at study Visit 5 (2011 to 2013). Six LA parameters [LA maximum/minimum volume index, ejection fraction, and LA reservoir, conduit, and contractile longitudinal strains (LS)] were compared between V122I TTR variant carriers (n = 46) and non-carriers (n = 1179). LA minimum volume index was significantly greater and LA contractile LS was worse in carriers than non-carriers (19.5 ± 10.6 mL/m 2 vs. 16.3 ± 8.4 mL/m 2 ; 15.0 ± 5.8% vs. 16.8 ± 5.7%, respectively, both P < 0.05). Carriers had a significantly higher number of LA abnormalities than non-carriers (1.8 ± 2.2 vs. 1.1 ± 1.6, P = 0.009). The number of subjects with at least four LA abnormalities was significantly increased among carriers compared with non-carriers (27% vs. 12%; odds ratio 2.43; 95% confidence interval 1.06-5.58 after adjusting for age, sex, body mass index, and LV wall thickness and global LS).

CONCLUSIONS: Left atrial enlargement and dysfunction were common in V122I TTR carriers with sinus rhythm than non-carriers, suggesting that abnormalities of LA function may represent early markers of subclinical disease in these individuals.

Original languageEnglish (US)
Pages (from-to)1290-1295
Number of pages6
JournalEuropean Journal of Heart Failure
Issue number8
StatePublished - Aug 2021

Bibliographical note

Publisher Copyright:
© 2021 European Society of Cardiology.


  • Cardiac amyloidosis
  • Echocardiography
  • Left atrium
  • Ventricular Function, Left
  • African Americans/genetics
  • Humans
  • Prealbumin/genetics
  • Heart Atria/diagnostic imaging
  • Stroke Volume
  • Aged, 80 and over
  • Heart Failure
  • Cardiomyopathies
  • Aged

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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