Estimating the Prevalence of Cardiac Amyloidosis in Old Patients with Heart Failure-Barriers and Opportunities for Improvement: The PREVAMIC Study.

Autor: Ruiz-Hueso R; Internal Medicine Department, Hospital Universitario Virgen Macarena, Avda. Dr. Fedriani, 3, 41009 Sevilla, Spain., Salamanca-Bautista P; Internal Medicine Department, Hospital Universitario Virgen Macarena, Avda. Dr. Fedriani, 3, 41009 Sevilla, Spain.; Department of Medicine, Universidad de Sevilla, San Fernando, 4, 41004 Sevilla, Spain., Quesada-Simón MA; Internal Medicine Department, Hospital Universitario La Paz, Plaza de la Castellana, 261, 28046 Madrid, Spain., Yun S; Community Heart Failure Program, Cardiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Carrer de la Feixa Llarga, s/n., 08907 Barcelona, Spain.; Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.; Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08907 Barcelona, Spain., Conde-Martel A; Internal Medicine Department, Hospital Universitario Dr. Negrín, Pl. Barranco de la Ballena s/n. 35010 Las Palmas de Gran Canaria, Spain., Morales-Rull JL; Internal Medicine Deparment, Hospital Universitario Arnau de Vilanova, IRBLleida, Avda. Alcalde Rovira Roure, 80, 25198 Lérida, Spain., Suárez-Gil R; Internal Medicine Department, Hospital Universitario Lucus Augusti, Rua Dr. Ulises Romero, 1, 27003 Lugo, Spain., García-García JÁ; Internal Medicine Department, Hospital Universitario Virgen del Valme, Ctra. Cádiz, km 548,9, 41014 Sevilla, Spain., Llàcer P; Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, M-607, 9, 100, 28034 Madrid, Spain., Fonseca-Aizpuru EM; Internal Medicine Department, Hospital de Cabueñes, C/Los Prados, 395, 33394 Gijón, Spain., Amores-Arriaga B; Internal Medicine Deparment, Hospital Universitario Lozano Blesa, C/San Juan Bosco, 15, 50009 Zaragoza, Spain., Martínez-González Á; Internal Medicine Department, C/Altos de Nava, s/n., 24071 León, Spain., Armengou-Arxe A; Internal Medicine Department, Leon University Hospital Complex, Hospital Universitario Josep Trueta, Avinguda de Franca s/n., 17007 Gerona, Spain., Peña-Somovilla JL; Internal Medicine Department, Hospital San Pedro., C/Piqueras, 98, 26006 Logroño, Spain., López-Reboiro ML; Internal Medicine Department, Hospital Comarcal Monforte de Lemos., Rua Corredoira s/n., 27400 Monforte de Lemos, Spain., Aramburu-Bodas Ó; Internal Medicine Department, Hospital Universitario Virgen Macarena, Avda. Dr. Fedriani, 3, 41009 Sevilla, Spain.; Department of Medicine, Universidad de Sevilla, San Fernando, 4, 41004 Sevilla, Spain.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2023 Mar 15; Vol. 12 (6). Date of Electronic Publication: 2023 Mar 15.
DOI: 10.3390/jcm12062273
Abstrakt: Background: Cardiac amyloidosis (CA) could be a common cause of heart failure (HF). The objective of the study was to estimate the prevalence of CA in patients with HF.
Methods: Observational, prospective, and multicenter study involving 30 Spanish hospitals. A total of 453 patients ≥ 65 years with HF and an interventricular septum or posterior wall thickness > 12 mm were included. All patients underwent a 99m Tc-DPD/PYP/HMDP scintigraphy and monoclonal bands were studied, following the current criteria for non-invasive diagnosis. In inconclusive cases, biopsies were performed.
Results: The vast majority of CA were diagnosed non-invasively. The prevalence was 20.1%. Most of the CA were transthyretin (ATTR-CM, 84.6%), with a minority of cardiac light-chain amyloidosis (AL-CM, 2.2%). The remaining (13.2%) was untyped. The prevalence was significantly higher in men (60.1% vs 39.9%, p = 0.019). Of the patients with CA, 26.5% had a left ventricular ejection fraction less than 50%.
Conclusions: CA was the cause of HF in one out of five patients and should be screened in the elderly with HF and myocardial thickening, regardless of sex and LVEF. Few transthyretin-gene-sequencing studies were performed in older patients. In many patients, it was not possible to determine the amyloid subtype.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje