TY - JOUR
T1 - Transthyretin cardiac amyloidosis in aortic stenosis
T2 - prevalence, diagnostic challenges and clinical implications
AU - Balciunaite, Giedre
AU - Rimkus, Arnas
AU - Zurauskas, Edvardas
AU - Zaremba, Tomas
AU - Palionis, Darius
AU - Valeviciene, Nomeda
AU - Aidietis, Audrius
AU - Serpytis, Pranas
AU - Rucinskas, Kestutis
AU - Sogaard, Peter
AU - Glaveckaite, Sigita
N1 - Copyright © 2019 Hellenic Society of Cardiology. Published by Elsevier B.V. All rights reserved.
PY - 2020/4
Y1 - 2020/4
N2 - Transthyretin cardiac amyloidosis (ATTR-CA) is a challenging and underdiagnosed cause of heart failure. Advances in cardiac imaging have enabled noninvasive diagnosis of ATTR-CA, causing the recent upsurge in disease awareness and detection. ATTR-CA has been increasingly recognized in patients with degenerative aortic stenosis (AS). With the growing number of elderly patients undergoing aortic valve intervention, the identification of ATTR-CA in this group of patients is of high clinical importance. Timely and correct diagnosis is essential for amyloid-directed therapies, as well as deciding on the AS treatment strategy. This review provides a comprehensive overview of the recent studies investigating coexistence of these two entities. We present the data on the prevalence of ATTR-CA in AS and their prognostic associations. As the diagnosis of ATTR-CA may be challenging, special attention is paid to the diagnostic utility of different imaging modalities, namely, echocardiography, cardiovascular magnetic resonance, nuclear imaging, and distinctive imaging features, in patients with dual pathology. We also present a flowchart summarizing integrated imaging in patients with suspected ATTR-CA.
AB - Transthyretin cardiac amyloidosis (ATTR-CA) is a challenging and underdiagnosed cause of heart failure. Advances in cardiac imaging have enabled noninvasive diagnosis of ATTR-CA, causing the recent upsurge in disease awareness and detection. ATTR-CA has been increasingly recognized in patients with degenerative aortic stenosis (AS). With the growing number of elderly patients undergoing aortic valve intervention, the identification of ATTR-CA in this group of patients is of high clinical importance. Timely and correct diagnosis is essential for amyloid-directed therapies, as well as deciding on the AS treatment strategy. This review provides a comprehensive overview of the recent studies investigating coexistence of these two entities. We present the data on the prevalence of ATTR-CA in AS and their prognostic associations. As the diagnosis of ATTR-CA may be challenging, special attention is paid to the diagnostic utility of different imaging modalities, namely, echocardiography, cardiovascular magnetic resonance, nuclear imaging, and distinctive imaging features, in patients with dual pathology. We also present a flowchart summarizing integrated imaging in patients with suspected ATTR-CA.
KW - Aortic stenosis
KW - Cardiac amyloidosis
KW - Transthyretin
UR - http://www.scopus.com/inward/record.url?scp=85078833352&partnerID=8YFLogxK
U2 - 10.1016/j.hjc.2019.10.004
DO - 10.1016/j.hjc.2019.10.004
M3 - Review article
C2 - 31740363
SN - 1109-9666
VL - 61
SP - 92
EP - 98
JO - Hellenic Journal of Cardiology
JF - Hellenic Journal of Cardiology
IS - 2
ER -