Key result
Over ~71% of HFpEF patients show three or more clinical signs suggesting ATTR-CM.
Why the study?
The prevalence of clinical manifestations of transthyretin amyloid cardiomyopathy (ATTR-CM) and associated clinical characteristics in patients with HFpEF in Russia were not well defined in real-world practice.
Observational (n=1,770)
Yes
More than two-thirds of Russian patients with HFpEF present with ≥3 clinical 'red flags' for ATTR-CM, highlighting the need for increased clinician awareness and standardized diagnostic algorithms to identify this underdiagnosed condition.
May warrant ATTR-CM screening consideration in HFpEF; leaves open need for prospective validation.
Aim. To assess the prevalence of clinical manifestations of transthyretin amyloid cardiomyopathy (ATTR-CM), as well as to analyze the demographic and clinical characteristics of patients, including paraclinical investigations conducted in this sample, in patients with heart failure with preserved ejection fraction (HFpEF) in Russia according to the real-world study. Material and methods. As part of the retrospective part, we analyzed the data of patients with HFpEF previously included in a prospective observational multicenter registry study of heart failure in research centers with ability to diagnose ATTR-CM. Symptoms and signs associated with a high probability of ATTR-CM ("red flags") were recorded based on anamnestic and paraclinical data. Based on interim analysis (n=1770, 29,5% of the planned number of patients), we decided to stop the study and not conduct a prospective phase that involved verifying the diagnosis of ATTRCM in patients with a high risk of its presence. Results. The mean age of the included patients was 69,7±10,0 years (women, 55,8% (n=988)). Left ventricular (LV) posterior wall thickness (PWT) was measured in 1704 (96,3%) patients. It exceeded 12 mm in 287 (16,8%) cases. Possible signs of ATTR-CM were detected in 1702 (96,2%) participants. Three or more possible signs of ATTR-CM were detected in 1262 (71,3%) patients in the general population. Among patients with available LV PWT measurements, 219 (76,3%) participants with thickness >12 mm had ≥3 possible signs of ATTR-CM. Using the risk calculator, only 117 (7,33%) patients had a high probability of this disease. Conclusion. More than two thirds of patients with HFpEF have several clinical signs associated with a high risk of ATTR-CM. About 7% of patients selected using the risk calculator may be primary candidates for examination to verify the diagnosis. However, determining the optimal algorithm for diagnosing ATTRCM requires further study.
No takes yet. Share an insight, caveat, or question.
Моисеева et al. (2025) conducted an observational in Heart failure with preserved ejection fraction (HFpEF) (n=1,770). Clinical signs of transthyretin amyloid cardiomyopathy was evaluated on Prevalence of ≥3 possible clinical signs of ATTR-CM. Among patients with heart failure with preserved ejection fraction, 71.3% had three or more clinical signs associated with a high probability of transthyretin amyloid cardiomyopathy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: