**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.**
Paul Geenty  - Department of Cardiology, Westmead Hospital, Sydney, NSW Australia

**Main Body of the Abstract**
Background: Transthyretin cardiac amyloidosis (ATTR-CA) results in a progressive, restrictive cardiomyopathy. Conventional staging utilises serum biomarkers (NT-proBNP, troponin and eGFR); however limitations include variations in assays between centres. We investigated conventional biomarker and novel echocardiographic techniques in predicting mortality in ATTR-CA.
Method: Consecutive patients seen in a quaternary referral amyloidosis centre in Sydney, Australia, who underwent transthoracic echocardiogram were retrospectively recruited. All patients had ATTR-CA diagnosis confirmed by bone scintigraphy in the absence of a monoclonal gammopathy, or by endomyocardial biopsy. The outcome of all-cause mortality was monitored through patient medical records.

Results: 133 patients were consecutively enrolled. Over a median follow-up of 2.1 years, 31/133 (23%) died. Patients who died were older (81±7 vs 75±11 years, p <0.001), more likely to be male (97% vs 73%, p=0.028), with more renal dysfunction (eGFR 56±19 vs 67±19, p=0.007). Non-survivors had greater indexed LV mass (193±52g/m 2 vs 155±45g/m 2 , p<0.001) and left atrial volume (61.4±16mL/m 2 vs 53.6±16mL/m 2 , p=0.023), as well as more pronounced reduction in systolic function including LVEF (52±7% vs 55±10%, p=0.032) and LVGLS (10.8±2.7% vs 12.8±4.1%, p=0.003). A composite echocardiographic risk score comprising LVGLS and indexed left atrial volume (LAVI) stratified patients into 3 distinct prognostic groups, akin to conventional staging systems.

Conclusion: Both conventional biomarkers and novel echocardiographic parameters are predictors of outcome in ATTR-CA. A novel echocardiographic prognostic score stratified patients into distinct risk groups, identifying a low-risk group with excellent long-term prognosis. Further evaluation by validation in another patient cohort is required.



**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.**
Paul Geenty  - Department of Cardiology, Westmead Hospital, Sydney, NSW Australia

**Main Body of the Abstract**
**Background**: Transthyretin cardiac amyloidosis (ATTR-CA) results in a progressive, restrictive cardiomyopathy. Conventional staging utilises serum biomarkers (NT-proBNP, troponin and eGFR); however limitations include variations in assays between centres. We investigated conventional biomarker and novel echocardiographic techniques in predicting mortality in ATTR-CA.
Method: Consecutive patients seen in a quaternary referral amyloidosis centre in Sydney, Australia, who underwent transthoracic echocardiogram were retrospectively recruited. All patients had ATTR-CA diagnosis confirmed by bone scintigraphy in the absence of a monoclonal gammopathy, or by endomyocardial biopsy. The outcome of all-cause mortality was monitored through patient medical records.

**Results:** 133 patients were consecutively enrolled. Over a median follow-up of 2.1 years, 31/133 (23%) died. Patients who died were older (81±7 vs 75±11 years, p <0.001), more likely to be male (97% vs 73%, p=0.028), with more renal dysfunction (eGFR 56±19 vs 67±19, p=0.007). Non-survivors had greater indexed LV mass (193±52g/m 2 vs 155±45g/m 2 , p<0.001) and left atrial volume (61.4±16mL/m 2 vs 53.6±16mL/m 2 , p=0.023), as well as more pronounced reduction in systolic function including LVEF (52±7% vs 55±10%, p=0.032) and LVGLS (10.8±2.7% vs 12.8±4.1%, p=0.003). A composite echocardiographic risk score comprising LVGLS and indexed left atrial volume (LAVI) stratified patients into 3 distinct prognostic groups, akin to conventional staging systems.

**Conclusion:** Both conventional biomarkers and novel echocardiographic parameters are predictors of outcome in ATTR-CA. A novel echocardiographic prognostic score stratified patients into distinct risk groups, identifying a low-risk group with excellent long-term prognosis. Further evaluation by validation in another patient cohort is required.



Echocardiographic Parameters for Risk Stratification in ATTR cardiac amyloidosis PB145 (#565)

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.