Heart Rate Variability As A Predictor Of Mortality In Patients With Aa And Al Amyloidosis

Aims Patients with AA and AL amyloidosis have a limited life-expectancy. The aim of this study was to investigate whether heart rate variability can predict mortality in these patients.Methods and Results Twenty-two recently diagnosed patients with AA and 23 patients with AL amyloidosis were included, Fifteen patients (5 AA, 10 AL) died within 1 year. Twenty-four hour Holter recording was performed to quantify the mean or all normal to normal RR-intervals (mean NN) and the standard deviation of all normal to normal RR-intervals (SDNN). The SDNN predicted 1-year mortality in the total group of patients with amyloidosis. The median SDNN was 73 ms. In patients with an SDNN less than or equal to 73 ms, the risk of dying within 1 year was found to have increased 3.5-fold (P=0.0036; 95% CI 1.1 11.0). An SDNN less than or equal to 50 ms, a predictor of mortality in other patient groups, increased the risk of dying within 1 year 22-fold (P=0.0001; 95% CI 5.4-90.4). In contrast to patients with AA amyloidosis, in the subgroup analysis of patients with AL amyloidosis the SDNN remained a predictive parameter (SDNN less than or equal to 50ms: risk ratio 11.5, 95% CI 2.4-56.2, P=0.0025).Conclusion The SDNN is a strong predictor of short-term mortality in patients with AL amyloidosis. (C) 2002 The European Society of Cardiology.