Screening for Transthyretin Amyloid Cardiomyopathy in Everyday Practice

Ronald M. Witteles, Sabahat Bokhari, Thibaud Damy, Perry M. Elliott, Rodney H. Falk, Nowell M. Fine, Mariana Gospodinova, Laura Obici, Claudio Rapezzi, Pablo Garcia-Pavia

Research output: Contribution to journalReview article

Abstract

Transthyretin amyloid cardiomyopathy (ATTR-CM) is a life-threatening, progressive, infiltrative disease caused by the deposition of transthyretin amyloid fibrils in the heart, and can often be overlooked as a common cause of heart failure. Delayed diagnosis due to lack of disease awareness and misdiagnosis results in a poorer prognosis. Early accurate diagnosis is therefore key to improving patient outcomes, particularly in the context of both the recent approval of tafamidis in some countries (including the United States) for the treatment of ATTR-CM, and of other promising therapies under development. With the availability of scintigraphy as an inexpensive, noninvasive diagnostic tool, the rationale to screen for ATTR-CM in high-risk populations of patients is increasingly warranted. Here the authors propose a framework of clinical scenarios in which screening for ATTR-CM is recommended, as well as diagnostic “red flags” that can assist in its diagnosis among the wider population of patients with heart failure.

Original languageEnglish
Pages (from-to)709-716
Number of pages8
JournalJACC: Heart Failure
Volume7
Issue number8
DOIs
Publication statusPublished - Aug 1 2019

Keywords

  • amyloidosis
  • cardiomyopathy
  • diagnosis
  • identification
  • transthyretin amyloid

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Witteles, R. M., Bokhari, S., Damy, T., Elliott, P. M., Falk, R. H., Fine, N. M., Gospodinova, M., Obici, L., Rapezzi, C., & Garcia-Pavia, P. (2019). Screening for Transthyretin Amyloid Cardiomyopathy in Everyday Practice. JACC: Heart Failure, 7(8), 709-716. https://doi.org/10.1016/j.jchf.2019.04.010