Unrecognized wild-type transthyretin amyloidosis may be present in up to 10% to 15% of older adults with heart failure, highlighting the need for early noninvasive diagnosis and emerging therapies.
Older adults with heart failure, specifically focusing on transthyretin amyloid cardiomyopathy (ATTR-CM)
Transthyretin amyloid cardiomyopathy is an under-recognized cause of heart failure in older adults that can now be diagnosed noninvasively and treated with disease-modifying pharmaceutical therapies.
Transthyretin amyloid cardiomyopathy (ATTR-CM) is an under-recognized cause of heart failure (HF) in older adults, resulting from myocardial deposition of misfolded transthyretin (TTR) or pre-albumin. Characteristic patterns of echocardiography and cardiac magnetic resonance can strongly suggest the disease but are not diagnostic. The diagnosis can be made with noninvasive nuclear imaging when there is no evidence of a monoclonal protein. Amyloid fibril formation results from a destabilizing mutation in hereditary ATTR amyloidosis (hATTR) or from an aging-linked process in wild-type ATTR amyloidosis (wtATTR). Recent studies have suggested that up to 10% to 15% of older adults with HF may have unrecognized wtATTR. Associated features, including carpal tunnel syndrome and lumbar spinal stenosis, raise suspicion and may afford a means for early diagnosis. Previously treatable only by organ transplantation, pharmaceutical therapy that slows or halts ATTR-CM progression and favorably affects clinical outcomes is now available. Early recognition remains essential to afford the best treatment efficacy.
Building similarity graph...
Analyzing shared references across papers
Frederick L. Ruberg
Martha Grogan
Mazen Hanna
Journal of the American College of Cardiology
Boston University
Mayo Clinic
Scripps Research Institute
Building similarity graph...
Analyzing shared references across papers
Ruberg et al. (Sat,) conducted a review in Transthyretin amyloid cardiomyopathy (ATTR-CM). Unrecognized wild-type transthyretin amyloidosis may be present in up to 10% to 15% of older adults with heart failure, highlighting the need for early noninvasive diagnosis and emerging therapies.
www.synapsesocial.com/papers/69ed841f27c2c78c57d1e0cc — DOI: https://doi.org/10.1016/j.jacc.2019.04.003
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: