Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.
Samsam A. Dahir, Brigham and Women's Hospital, Boston Massachusetts

Main Body of the Abstract
Six-minute walk test (6MWT) is often used to assess functional capacity in a wide variety of cardiovascular conditions and is an important endpoint in trials of therapeutics for ATTR cardiomyopathy (ATTR-CM). However, 6MWT may be impacted by multiple factors including frailty. We therefore investigated the impact both of cardiac disease burden and frailty on 6MWT distance in patients with ATTR-CM.  6MWT and other clinical data were prospectively collected in 118 ATTR-CM patients. Short Performance Physical Battery (SPPB) was measured to assess frailty. Statistical analysis was performed to evaluate the effect of age and disease burden (NTproBNP, global longitudinal LV strain (GLS), eGFR, diastolic function and NYHA class) and frailty (per SPBB score) on 6MWT distance. 93.9% of patients were male, median age 78.5 years (IQR 73, 83). The average 6MWT distance was 326 ± 107m. On univariate analysis, age, SPPB score, eGFR, NT-proBNP, GLS, diastolic function and NYHA class were all associated with 6MWT distance. However, on multivariate analysis, the SPPB score remained the only independent predictor of 6 MWT distance (p<0.001).  Although cardiac dysfunction is a driver of 6MWT distance, baseline frailty is a more important factor.  Clinical trials that do not consider baseline frailty as a potential confounder in 6MWT distance may over- or underestimate the effect of a drug on cardiac function. Thus, we recommend that future clinical trials of drug therapy stratify ATTR-CM patients by baseline frailty whenever utilizing the 6MWT as an endpoint.

**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Samsam A. Dahir, Brigham and Women's Hospital, Boston Massachusetts

**Main Body of the Abstract**
Six-minute walk test (6MWT) is often used to assess functional capacity in a wide variety of cardiovascular conditions and is an important endpoint in trials of therapeutics for ATTR cardiomyopathy (ATTR-CM). However, 6MWT may be impacted by multiple factors including frailty. We therefore investigated the impact both of cardiac disease burden and frailty on 6MWT distance in patients with ATTR-CM.  6MWT and other clinical data were prospectively collected in 118 ATTR-CM patients. Short Performance Physical Battery (SPPB) was measured to assess frailty. Statistical analysis was performed to evaluate the effect of age and disease burden (NTproBNP, global longitudinal LV strain (GLS), eGFR, diastolic function and NYHA class) and frailty (per SPBB score) on 6MWT distance. 93.9% of patients were male, median age 78.5 years (IQR 73, 83). The average 6MWT distance was 326 ± 107m. On univariate analysis, age, SPPB score, eGFR, NT-proBNP, GLS, diastolic function and NYHA class were all associated with 6MWT distance. However, on multivariate analysis, the SPPB score remained the only independent predictor of 6 MWT distance (p<0.001).  Although cardiac dysfunction is a driver of 6MWT distance, baseline frailty is a more important factor.  Clinical trials that do not consider baseline frailty as a potential confounder in 6MWT distance may over- or underestimate the effect of a drug on cardiac function. Thus, we recommend that future clinical trials of drug therapy stratify ATTR-CM patients by baseline frailty whenever utilizing the 6MWT as an endpoint.

The Impact of Frailty and Cardiac Amyloid Burden on 6-minute walk distance in ATTR cardiomyopathy. PC62 (#323)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.