• Cardiac failure review · Mar 2020

    Review

    Cardiac Transthyretin-derived Amyloidosis: An Emerging Target in Heart Failure with Preserved Ejection Fraction?

    • Sebastiaan Hc Klaassen, Dirk J van Veldhuisen, Hans LA Nienhuis, Maarten P van den Berg, Bouke Pc Hazenberg, and Peter van der Meer.
    • Department of Cardiology, University of Groningen, University Medical Center Groningen Groningen, the Netherlands.
    • Card Fail Rev. 2020 Mar 1; 6: e21.

    AbstractHeart failure with preserved ejection fraction (HFpEF) comprises half of the heart failure population. A specific, but underdiagnosed, cause for HFpEF is transthyretin-derived (ATTR) amyloidosis. This article reviews the clinical characteristics of cardiac ATTR amyloidosis. The clinical suspicion of cardiac ATTR amyloidosis is strong if pronounced left ventricular hypertrophy is present in the absence of hypertension. Scintigraphy with a diphosphonate tracer is a diagnostic tool for the early detection of cardiac ATTR amyloidosis with high sensitivity and specificity. First treatment options for ATTR amyloidosis recently emerged, and showed a reduction in morbidity and mortality, especially if treatment was started in the early stages of disease. In light of these results, screening for ATTR amyloidosis in the general HFpEF population with left ventricular hypertrophy might be useful.Copyright © 2020, Radcliffe Cardiology.

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