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Analysis of institutional authors

Garcia-Pavia, PAuthor

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July 20, 2023
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Article

Prognosis of Transthyretin Cardiac Amyloidosis Without Heart Failure Symptoms

Publicated to: JACC: CardioOncology. 4 (4): 442-454 - 2022-11-15 4(4), DOI: 10.1016/j.jaccao.2022.07.007

Authors:

Gonzalez-Lopez, Esther; Escobar-Lopez, Luis; Obici, Laura; Saturi, Giulia; Bezard, Melanie; Saith, Sunil E; AbouEzzeddine, Omar F; Mussinelli, Roberta; Gagliardi, Christian; Kharoubi, Mounira; Griffin, Jan M; Dispenzieri, Angela; Vilches, Silvia; Perlini, Stefano; Longhi, Simone; Oghina, Silvia; Rivas, Adrian; Grogan, Martha; Maurer, Mathew S; Damy, Thibaud; Palladini, Giovanni; Rapezzi, Claudio; Garcia-Pavia, Pablo
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Affiliations

Columbia Univ, Irving Med Ctr, Dept Med, Div Cardiol, New York, NY USA - Author
Columbia University Irving Medical Center - Author
Ctr Hosp Univ Henri Mondor, GRC Amyloid Res Inst, Dept Cardiol, Referral Ctr Cardiac Amyloidosis,DHU ATVB, Creteil, France - Author
Ctr Nacl Invest Cardiovasc, Madrid, Spain - Author
Fdn IRCCS Policlin S Matteo, Amyloidosis Res & Treatment Ctr, Pavia, Italy - Author
Fondazione IRCCS Policlinico San Matteo - Author
Fondazione IRCCS Policlinico San Matteo; Università degli Studi di Pavia - Author
Hosp Univ Puerta de Hierro, Heart Failure & Inherited Cardiac Dis Unit, Dept Cardiol, IDIPHISA,CIBERCV, Madrid, Spain - Author
Hospital Universitario Puerta de Hierro Majadahonda - Author
Hospital Universitario Puerta de Hierro Majadahonda; Universidad Francisco de Vitoria; Centro Nacional de Investigaciones Cardiovasculares Carlos III - Author
IRCCS Azienda Ospedaliero-Universitaria di Bologna - Author
Maria Cecilia Hosp, GVM Care & Res, Cotignola, Italy - Author
Mayo Clin, Dept Cardiovasc Dis, Rochester, MN USA - Author
Mayo Clinic - Author
St Orsola Marcello Malpighi Hosp, Bologna, Italy - Author
Univ Bologna, Dept Diagnost Expt & Specialty Med, Cardiol, Bologna, Italy - Author
Univ Ferrara, Cardiovasc Ctr, Ferrara, Italy - Author
Univ Francisco de Vitoria, Pozuelo De Alarcon, Spain - Author
Univ Paris Est Creteil, Inserm U955, Creteil, France - Author
Univ Pavia, Emergency Dept, Dept Internal Med, Fdn IRCCS Policlin S Matteo, Pavia, Italy - Author
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Abstract

Transthyretin amyloid cardiomyopathy (ATTR-CM) is increasingly recognized as a treatable cause of heart failure (HF). Advances in diagnosis and therapy have increased the number of patients diagnosed at early stages, but prognostic data on patients without HF symptoms are lacking. Moreover, it is unknown whether asymptomatic patients benefit from early initiation of transthyretin (TTR) stabilizers.The aim of this study was to describe the natural history and prognosis of ATTR-CM in patients without HF symptoms.Clinical characteristics and outcomes of patients with ATTR-CM without HF symptoms were retrospectively collected at 6 international amyloidosis centers.A total of 118 patients (78.8% men, median age 66 years [IQR: 53.8-75 years], 68 [57.6%] with variant transthyretin amyloidosis, mean left ventricular ejection fraction 60.5% ± 9.9%, mean left ventricular wall thickness 15.4 ± 3.1 mm, and 53 [45%] treated with TTR stabilizers at baseline or during follow-up) were included. During a median follow-up period of 3.7 years (IQR: 1-6 years), 38 patients developed HF symptoms (23 New York Heart Association functional class II and 14 functional class III or IV), 32 died, and 2 required cardiac transplantation. Additionally, 20 patients received pacemakers, 13 developed AF, and 1 had a stroke. Overall survival was 96.5% (95% CI: 91%-99%), 90.4% (95% CI: 82%-95%), and 82% (95% CI: 71%-89%) at 1, 3, and 5 years, respectively. Treatment with TTR stabilizers was associated with improved survival (HR: 0.31; 95% CI: 0.12-0.82; P = 0.019) and remained significant after adjusting for sex, age, ATTR-CM type, and estimated glomerular filtration rate (HR: 0.18; 95% CI: 0.06-0.55; P = 0.002).After a median follow-up period of 3.7 years, 1 in 3 patients with asymptomatic ATTR-CM developed HF symptoms, and nearly as many died or required cardiac transplantation. Treatment with TTR stabilizers was associated with improved prognosis.© 2022 The Authors.
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Keywords

af, atrial fibrillationattr-cm, transthyretin amyloid cardiomyopathyattr-v, variant transthyretin amyloidosisattr-wt, wild-type transthyretin amyloidosiscardiac amyloidosiscv, cardiovascularearly stagesegfr, estimated glomerular filtration rateheart failurehf, heart failurenac, national amyloid centernt-probnp, n-terminal pro–brain natriuretic peptidenyha, new york heart associationshr, subdistribution hrstabilizersttr, transthyretinTransthyretin

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal JACC: CardioOncology due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2022, it was in position 11/143, thus managing to position itself as a Q1 (Primer Cuartil), in the category Cardiac & Cardiovascular Systems. Notably, the journal is positioned above the 90th percentile.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 4.33. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 13, 2025)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Weighted Average of Normalized Impact by the Scopus agency: 4.77 (source consulted: FECYT Mar 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2026-04-04, the following number of citations:

  • WoS: 36
  • Scopus: 42
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Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2026-04-04:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 51.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 51 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 50.
  • The number of mentions on the social network Facebook: 1 (Altmetric).
  • The number of mentions on the social network X (formerly Twitter): 68 (Altmetric).
  • The number of mentions in news outlets: 1 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
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Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: France; Italy; United States of America.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: Last Author (GARCIA PAVIA, PABLO).

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