Cardiac amyloidosis: An underdiagnosed/underappreciated disease

European Journal of Internal Medicine
Antonis S ManolisHelen Melita

Abstract

Cardiac amyloidosis or amyloid cardiomyopathy (ACM), commonly resulting from extracellular deposition of amyloid fibrils consisted of misfolded immunoglobulin light chain (AL) or transthyretin (TTR) protein, is an underestimated cause of heart failure and cardiac arrhythmias. Among the three types of cardiac amyloidosis (wild-type or familial TTR and light-chain), the wild-type (Wt) TTR-related amyloidosis (ATTR) is an increasingly recognized cause of heart failure with preserved ejection fraction (HFpEF), and amyloidosis should be considered in the differential diagnosis of this heart failure group of patients. Recent advances in the diagnosis and drug treatment of ACM have ushered in a new era in early disease detection and better management of these patients. Certain clues in cardiac and extracardiac manifestations of ACM may heighten clinical suspicion and guide further confirmatory testing. Newer noninvasive imaging methods (strain echocardiography, cardiac magnetic resonance and bone scintigraphy) may obviate the need for endomyocardial biopsy in ATTR patients, while newer targeted therapies may alter the adverse prognosis in these patients. Early recognition of ACM is crucial in halting the disease process before irrever...Continue Reading

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Citations

Oct 12, 2019·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Riemer H J A SlartBouke P C Hazenberg
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Mar 10, 2021·Current Cardiology Reports·Chuanfen LiuYuchi Han
May 1, 2021·Postgraduate Medical Journal·Akash BattaRajesh Vijayvergiya

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