Transthyretin cardiac amyloidosis
Why the study?
Advances in non-invasive diagnosis and effective therapies have shifted ATTR-CA to an increasingly recognized, prevalent cause of HF and mortality requiring early recognition.
Design
Review
Authors
Discussion
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Implication
Supports heightened suspicion for amyloidosis in HFpEF; leaves open optimal screening strategies and outcome impact.
Key Points
- To review the evolving epidemiology, pathophysiology, non-invasive diagnostic strategies, and emerging treatment options for transthyretin cardiac amyloidosis.
- Synthesized observational and longitudinal epidemiological data on wild-type and hereditary variant transthyretin cardiac amyloidosis.
- Evaluated diagnostic performance of multimodality imaging, including echocardiography, cardiac magnetic resonance, and bone-tracer radionuclide scintigraphy.
- Contemporary incidence estimates in the United States reach 17 per 100,000, up from previous historical estimates of 0.5 per 100,000.
- Cardiac amyloid involvement is identified in up to 15% of patients hospitalized with heart failure with preserved ejection fraction and represents the primary driver of mortality.
- Available disease-modifying therapies halt or slow disease progression and improve survival, particularly when initiated early before advanced heart failure develops.
Cite This Study
Porcari et al. (2022) studied this question.