Cardiac amyloidosis, encompassing both transthyretin (ATTR) and light-chain (AL) types, poses considerable challenges in patient management due to its intricate pathophysiology and progressive course. This narrative review elucidates the pivotal role of cardiopulmonary exercise testing (CPET) in the assessment of these patients. CPET is essential for evaluating disease progression by measuring cardio-respiratory performance and providing prognostic insights. This functional test is crucial not only for tracking the disease trajectory, but also for assessing the effectiveness of disease-modifying therapies. Moreover, CPET facilitates the customization of therapeutic strategies based on individual patient performance, enhancing personalized care. By objectively measuring parameters such as peak oxygen uptake (VO₂ peak), ventilatory efficiency, and exercise capacity, clinicians can gain a deeper understanding of the degree of functional impairment and make informed decisions regarding treatment initiation, adjustment, and anticipated outcomes. This review emphasizes the importance of CPET in advancing personalized medicine approaches, ultimately striving to improve the quality of life and clinical outcomes for patients with cardiac amyloidosis.

Among physiological parameters, total locomotor activity (TLA) and heart rate (HR) are used as physiological indicators in animal welfare evaluations. The present study aimed to simultaneously record for 24 h the TLA and HR of ten clinically healthy horses housed in conventional individual boxes subjected to a natural photoperiod and temperature. An actigraphy-based data logger was placed on the headstall, and an equine HR monitor was placed around the chest to monitor TLA and HR, respectively. Activity was monitored with 5 min sampling intervals and HR with 5 s intervals. To make the data points uniform, the means of 5 min intervals were calculated. Both investigated parameters showed a daily rhythmicity with a diurnal acrophase (locomotor activity 17:05 ± 1:15 arbitrary unit; heart rate 16.40 ± 0.30 beats/min). Robustness of the rhythm was 17.95 ± 10.53% and 37.05 ± 0.63% for the TLA and HR. A positive correlation was observed between the two investigated parameters in each horse, r = 0.48 ± 0.07, p < 0.0001. Change in TLA is a good index for success of management. Its positive correlation with daily HR monitoring confirms the use of these two physiological parameters for an objective on-farm welfare assessment. The application of new technologies for the simultaneous recording of physiological indexes of animals’ welfare can be a useful instrument.

Pugliatti P, et al. J Cardiovasc Ultrasound. 2016 Jun;24(2):177-178. http://dx.doi.org/10.4250/jcu.2016.24.2.177