What is the prevalence of transthyretin cardiac amyloidosis and its echocardiographic predictors among elderly patients with severe aortic stenosis undergoing TAVR?
ATTR-CA is present in 16% of elderly patients undergoing TAVR for severe AS, and a tissue Doppler mitral annular S' < 6 cm/s should prompt confirmatory testing for amyloidosis.
Transthyretin cardiac amyloidosis is prevalent in 16% of patients with severe calcific AS undergoing TAVR and is associated with a severe AS phenotype of low-flow low-gradient with mildly reduced ejection fraction. Average tissue Doppler mitral annular S' of < 6 cm/s may be a sensitive measure that should prompt a confirmatory 99mTc-PYP scan and subsequent testing for ATTR-CA. Prospective assessment of outcomes after TAVR is needed in patients with and without ATTR-CA.
Castaño et al. (2017) studied this question.