{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:41:30Z","timestamp":1788176490825,"version":"build-2803163510"},"reference-count":21,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Cardiac amyloidosis (CA) is frequently diagnosed in clinically stable patients, yet the risk of subsequent heart failure (HF) hospitalization remains difficult to predict using readily available tools. Early identification of high-risk outpatients is crucial to optimize follow-up and therapeutic strategies. Purpose: To develop a simple, non-invasive risk score to predict HF hospitalization in stable patients with cardiac amyloidosis using standard electrocardiographic and echocardiographic parameters. Methods: We prospectively enrolled 100 consecutive patients with confirmed cardiac amyloidosis from three tertiary centers. Baseline evaluation included clinical assessment, electrocardiography, and transthoracic echocardiography. The primary endpoint was HF hospitalization during follow-up; secondary endpoints were HF-related and all-cause mortality. Cox regression analysis was used to identify independent predictors of HF hospitalization and to derive a point-based risk (CAMY-HF) score. Results: During a median follow-up of 36 months, 55% of patients required HF hospitalization and 47% died. Low QRS voltage, interventricular septal thickness \u226514 mm, and left ventricular ejection fraction \u226440% independently predicted HF hospitalization and were incorporated into the CAMY-HF score (range, 0\u20134). HF hospitalization occurred in 0% of low-risk, 47.9% of intermediate-risk, and 80.6% of high-risk patients at 3 years. Higher CAMY-HF scores were also associated with increased HF-related and all-cause mortality. Conclusions: The CAMY-HF score is a simple, widely applicable tool for early risk stratification in clinically stable patients with cardiac amyloidosis. By relying on routine ECG and echocardiographic parameters, it may help identify outpatients at high risk of HF hospitalization and guide follow-up intensity and management strategies.<\/jats:p>","DOI":"10.3390\/jcm15052045","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T08:58:45Z","timestamp":1773046725000},"page":"2045","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cardiovascular Prognosis in Stable Patients with Cardiac Amyloidosis: A Novel and Simple Risk Score"],"prefix":"10.3390","volume":"15","author":[{"given":"Ilaria","family":"Dentamaro","sequence":"first","affiliation":[{"name":"University Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Guida","sequence":"additional","affiliation":[{"name":"Cardiology Division, Miulli Hospital, 70021 Acquaviva delle Fonti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0723-1023","authenticated-orcid":false,"given":"Yassin","family":"Belahnech","sequence":"additional","affiliation":[{"name":"Departamento de Cardiolog\u00eda, Hospital Universitari Vall d\u2019Hebron, 08035 Barcelona, Spain"},{"name":"Vall Hebr\u00f3n Institut de Recerca (VHIR), Universitat Aut\u00f2noma de Barcelona, 08193 Bellaterra, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4865-2522","authenticated-orcid":false,"given":"Marco Maria","family":"Dicorato","sequence":"additional","affiliation":[{"name":"University Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Basile","sequence":"additional","affiliation":[{"name":"University Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5094-2237","authenticated-orcid":false,"given":"Maria Cristina","family":"Carella","sequence":"additional","affiliation":[{"name":"University Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3767-7595","authenticated-orcid":false,"given":"Francesco","family":"Mangini","sequence":"additional","affiliation":[{"name":"Cardiology Division, Miulli Hospital, 70021 Acquaviva delle Fonti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0458-1469","authenticated-orcid":false,"given":"Eduardo","family":"Urgesi","sequence":"additional","affiliation":[{"name":"University Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Dentamaro","sequence":"additional","affiliation":[{"name":"Vascular Surgery, Polyclinic University Hospital, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9452-4037","authenticated-orcid":false,"given":"Cinzia","family":"Forleo","sequence":"additional","affiliation":[{"name":"University Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9347-8884","authenticated-orcid":false,"given":"Massimo","family":"Grimaldi","sequence":"additional","affiliation":[{"name":"Cardiology Division, Miulli Hospital, 70021 Acquaviva delle Fonti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Matteo","family":"Ciccone","sequence":"additional","affiliation":[{"name":"University Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7229-9780","authenticated-orcid":false,"given":"Jose F.","family":"Rodriguez-Palomares","sequence":"additional","affiliation":[{"name":"Departamento de Cardiolog\u00eda, Hospital Universitari Vall d\u2019Hebron, 08035 Barcelona, Spain"},{"name":"Vall Hebr\u00f3n Institut de Recerca (VHIR), Universitat Aut\u00f2noma de Barcelona, 08193 Bellaterra, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7133-4401","authenticated-orcid":false,"given":"Andrea Igoren","family":"Guaricci","sequence":"additional","affiliation":[{"name":"University Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1056\/NEJM199709253371306","article-title":"The systemic amyloidoses","volume":"337","author":"Falk","year":"1997","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1136\/hrt.2009.190405","article-title":"Amyloid diseases of the heart: Assessment, diagnosis, and referral","volume":"97","author":"Dubrey","year":"2011","journal-title":"Heart"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e000364","DOI":"10.1161\/JAHA.111.000364","article-title":"Updates in cardiac amyloidosis: A review","volume":"1","author":"Banypersad","year":"2012","journal-title":"J. Am. Heart Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1700","DOI":"10.1002\/ejhf.2606","article-title":"Progression of echocardiographic parameters and prognosis in transthyretin cardiac amyloidosis","volume":"24","author":"Chacko","year":"2022","journal-title":"Eur. J. Heart Fail."},{"key":"ref_5","first-page":"122","article-title":"Cardiac amyloidosis: Still challenging","volume":"38","author":"Laptseva","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Dicorato, M.M., Basile, P., Muscogiuri, G., Carella, M.C., Naccarati, M.L., Dentamaro, I., Guglielmo, M., Baggiano, A., Mushtaq, S., and Fusini, L. (2024). Novel Insights into Non-Invasive Diagnostic Techniques for Cardiac Amyloidosis: A Critical Review. Diagnostics, 14.","DOI":"10.3390\/diagnostics14192249"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1200\/JCO.2011.38.5724","article-title":"Revised prognostic staging system for light chain amyloidosis incorporating cardiac biomarkers and serum free light chain measurements","volume":"30","author":"Kumar","year":"2012","journal-title":"J. Clin. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2799","DOI":"10.1093\/eurheartj\/ehx589","article-title":"A new staging system for cardiac transthyretin amyloidosis","volume":"39","author":"Gillmore","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1442","DOI":"10.1136\/heartjnl-2012-302353","article-title":"Relative apical sparing of longitudinal strain using two-dimensional speckle-tracking echocardiography is both sensitive and specific for the diagnosis of cardiac amyloidosis","volume":"98","author":"Phelan","year":"2012","journal-title":"Heart"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2686","DOI":"10.1093\/eurheartj\/ehm379","article-title":"How to diagnose diastolic heart failure: A consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology","volume":"28","author":"Kindermann","year":"2007","journal-title":"Eur. Heart J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2585","DOI":"10.1093\/eurheartj\/ehv338","article-title":"Wild-type transthyretin amyloidosis as a cause of heart failure with preserved ejection fraction","volume":"36","author":"Robles","year":"2015","journal-title":"Eur. Heart J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"7746","DOI":"10.1038\/s41598-019-44245-9","article-title":"Associations of Electrocardiographic Parameters with Left Ventricular Longitudinal Strain and Prognosis in Cardiac Light Chain Amyloidosis","volume":"9","author":"Kim","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"oead048","DOI":"10.1093\/ehjopen\/oead048","article-title":"Prognostic value of right ventricular global longitudinal strain in patients with immunoglobulin light-chain cardiac amyloidosis","volume":"3","author":"Usuku","year":"2023","journal-title":"Eur. Heart J. Open"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/ehjci\/jev014","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"16","author":"Lang","year":"2015","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1016\/j.amjcard.2014.07.026","article-title":"Prevalence and prognostic significance of low QRS voltage among the three main types of cardiac amyloidosis","volume":"114","author":"Cyrille","year":"2014","journal-title":"Am. J. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1161\/CIRCULATIONAHA.105.584102","article-title":"The Seattle Heart Failure Model: Prediction of survival in heart failure","volume":"113","author":"Levy","year":"2006","journal-title":"Circulation"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.ijcard.2018.07.117","article-title":"Left ventricular ejection fraction for risk stratification in chronic systolic heart failure","volume":"273","author":"Aimo","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/j.recesp.2024.01.001","article-title":"Prognostic value of the tricuspid annular plane systolic excursion\/systolic pulmonary artery pressure ratio in cardiac amyloidosis","volume":"77","author":"Maccallini","year":"2024","journal-title":"Rev. Esp. Cardiol. Engl. Ed."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1093\/ehjci\/jead145","article-title":"Right ventricular to pulmonary artery coupling and outcome in patients with cardiac amyloidosis","volume":"24","author":"Tomasoni","year":"2023","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.recesp.2025.04.002","article-title":"Feature tracking cardiovascular magnetic resonance to predict major adverse cardiovascular events in patients with cardiac amyloidosis","volume":"79","author":"Dentamaro","year":"2026","journal-title":"Rev. Esp. Cardiol. Engl. Ed."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1016\/j.jcmg.2021.01.016","article-title":"Prognostic Utility of Echocardiographic Atrial and Ventricular Strain Imaging in Patients With Cardiac Amyloidosis","volume":"14","author":"Huntjens","year":"2021","journal-title":"JACC Cardiovasc. Imaging"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/5\/2045\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T09:23:12Z","timestamp":1773048192000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/5\/2045"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,7]]},"references-count":21,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jcm15052045"],"URL":"https:\/\/doi.org\/10.3390\/jcm15052045","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,7]]}}}