Cardiac Biomarkers in Patients With Transthyretin Amyloidosis as Documented in Thaos: The Transthyretin Amyloidosis Survey

Maurer, Mathew S.; Kristen, Arnt V.; Rapezzi, Claudio; Suhr, Ole B.; Kolluri, Sheela; Damy, Thibaud

doi:10.1016/s0735-1097(13)61244-9

Cited by 5 publications

(7 citation statements)

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“…Troponin concentrations are not as frequently elevated in ATTR as in AL cardiac amyloidosis, however emerging data suggests a prognostic role for ATTR. 58,59 …”

Section: Early Diagnostic Cluesmentioning

confidence: 99%

Transthyretin Cardiac Amyloidosis in Black Americans

Shah

Mankad

Castaño

et al. 2016

Circ: Heart Failure

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Transthyretin (TTR) related cardiac amyloidosis is a progressive infiltrative cardiomyopathy that mimics hypertensive, hypertrophic heart disease and often goes undiagnosed. In the United States, the hereditary form disproportionately afflicts Black Americans, who when compared to Caucasians with wild type TTR amyloidosis, a phenotypically similar condition, present with more advanced disease despite having a non-invasive method for early identification (genetic testing). While reasons for this are unclear, this begs to consider the inadequate access to care, societal factors or a biological basis. In an effort to improve awareness and explore unique characteristics, we review the pathophysiology, epidemiology and therapeutic strategies for TTR amyloidosis, and highlight diagnostic pitfalls and clinical pearls for identifying patients with amyloid heart disease.

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“…Troponin concentrations are not as frequently elevated in ATTR as in AL cardiac amyloidosis, however emerging data suggests a prognostic role for ATTR. 58,59 …”

Section: Early Diagnostic Cluesmentioning

confidence: 99%

Transthyretin Cardiac Amyloidosis in Black Americans

Shah

Mankad

Castaño

et al. 2016

Circ: Heart Failure

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“…High NT-proBNP is also observed in ATTR patients with cardiomyopathy [31][32][33], whereas troponin is elevated only in a minority of individuals in advanced stages [9,31], and does not correlate with IVS-thickness or basal strain [31]. The role of biomarkers in early diagnosis of ATTR, however, has been scarcely explored; indeed use of NT-proBNP to predict cardiac abnormalities and monitor the onset of cardiac amyloidosis in carriers of amyloidogenic TTR mutations, or in ATTR patients with only neurologic symptoms, has recently been proposed [34].…”

Section: Use Of Biomarkers For Early Diagnosismentioning

confidence: 99%

Biochemical markers in early diagnosis and management of systemic amyloidoses

Lavatelli

Albertini

Fonzo

et al. 2014

Clinical Chemistry and Laboratory Medicine (CCLM)

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Systemic amyloid diseases are characterized by widespread protein deposition as amyloid fibrils. Precise diagnostic framing is the prerequisite for a correct management of patients. This complex process is achieved through a series of steps, which include detection of the tissue amyloid deposits, identification of the amyloid type, demonstration of the amyloidogenic precursor, and evaluation of organ dysfunction/damage. Laboratory medicine plays a central role in the diagnosis and management of systemic amyloidoses, through the quantification of the amyloidogenic precursor and evaluation of end-organ damage using biomarkers.

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“…Syncope is common in patients with amyloid cardiomyopathy, and it has been associated with poor prognosis in the light chain subtype [10]; orthostatic hypotension [11] and cardiac arrhythmias [12] have been described as frequent underlying mechanisms. The previously reported prevalence of syncope in patients with ATTR-CM varies from 8% to 21.5% [4,13].…”

Section: Introductionmentioning

confidence: 93%

Syncope in patients with transthyretin amyloid cardiomyopathy: clinical features and outcomes

Barge‐Caballero

López‐Pérez

et al. 2022

Postgraduate Medicine

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Background:We aimed to describe the clinical characteristics, underlying causes and outcomes of syncope in patients with transthyretin amyloid cardiomyopathy (ATTR-CM). Methods:The clinical profile and underlying causes of syncopal episodes were reviewed in a cohort of 128 patients with ATTR-CM enrolled from January 2018 to June 2020 in a prospective multicentre registry in 7 hospitals of Galicia (Spain). After enrollment, patients were followed during a median period of 520 days.The effect of syncope on all-cause mortality was assessed by means of multivariate Cox´s regression.Results: Thirty (23.4%) patients had a history of previous syncope as a clinical antecedent before being enrolled in the prospective phase of the registry, and 4 (3.1%) experienced a first episode of syncope thereafter. The estimated incidence density rate of syncope during the prospective follow-up period after registry enrollment was 71.9 episodes per 1000 patients-year (95% Confidence Interval (CI) 32.8-111.1).The estimated overall prevalence of syncope was 26.6% (95% CI 18.9%-34.2%). Cardiac arrhythmias (n = 11, 32.3%), structural diseases of the heart or great vessels (n = 5, 14.7%), a neurally mediated reflex (n = 6, 17.6%), and orthostatic hypotension (n = 4, 11.8%) were identified as probable underlying causes of syncope; in 8 (23.6%) patients, syncope remained unexplained. Patients with syncope had increased nonadjusted all-cause mortality than patients without it (univariate hazard-ratio 3.37; 95% CI 1.43-7.94). When other independent predictors of survival were added to the survival model, this association was no longer statistically significant (multivariate hazard-ratio 1.81, 95% CI 0.67-4.84).Conclusions: Syncope is frequent in patients with ATTR-CM. This study could not demonstrate an independent association between syncope and mortality in those individuals.

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Cardiac Biomarkers in Patients With Transthyretin Amyloidosis as Documented in Thaos: The Transthyretin Amyloidosis Survey

Cited by 5 publications

References 0 publications

Transthyretin Cardiac Amyloidosis in Black Americans

Transthyretin Cardiac Amyloidosis in Black Americans

Biochemical markers in early diagnosis and management of systemic amyloidoses

Syncope in patients with transthyretin amyloid cardiomyopathy: clinical features and outcomes

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