[Wild-type transthyretin-related cardiac amyloidosis and degenerative aortic stenosis: Two inter-related pathologies

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Genetic Analysis of Hereditary Transthyretin Ala97Ser Related Amyloidosis
06:33

Genetic Analysis of Hereditary Transthyretin Ala97Ser Related Amyloidosis

Published on: June 9, 2018

8.2K

Sofía Calero Núñez1, Antonia Tercero Martínez1, Juan Carlos García López1

  • 1Servicio de Cardiología, Hospital General Universitario de Albacete, Albacete, España.

Revista Espanola De Geriatria Y Gerontologia
|June 14, 2016
PubMed

Insights

Wild-type transthyretin amyloidosis (ATTRwt) is often found with aortic stenosis. Researchers discovered ATTRwt in one third of patients who underwent transcatheter aortic valve replacement (TAVR), suggesting a need to reconsider treatment strategies.

Area of Science:

  • Cardiology
  • Cardiovascular Diseases
  • Amyloidosis

Background:

  • Wild-type transthyretin-related cardiac amyloidosis (ATTRwt) and degenerative aortic stenosis share similar patient demographics and clinical presentations.
  • Transcatheter aortic valve replacement (TAVR) is a common procedure for aortic stenosis.
  • Co-existing cardiac amyloidosis has been hypothesized as a cause for complications during and after TAVR.

Observation:

  • Autopsy studies of patients who underwent TAVR revealed ATTR amyloidosis in one-third of cases.
  • This report details two patients with aortic stenosis diagnosed with ATTRwt just before TAVI.
  • ATTRwt is a slowly progressive condition.

Findings:

  • A significant prevalence of ATTRwt was observed in patients undergoing TAVR for aortic stenosis.
  • The diagnostic findings highlight the frequent co-occurrence of these two conditions.
  • Case studies illustrate the clinical scenario of ATTRwt diagnosis preceding TAVI.

Implications:

  • The high rate of ATTRwt in TAVR patients necessitates a re-evaluation of therapeutic strategies.
  • Considering ATTRwt in patients with aortic stenosis is crucial for optimizing TAVR outcomes.
  • Further research is needed to refine treatment protocols for patients with both aortic stenosis and ATTRwt.

Keywords:
Amiloidosis cardiaca senilAncianoAortic stenosisElderlyEstenosis aórticaImplante percutáneo de prótesis valvular aórticaTranscatheter aortic valve replacementWild-Type Transthyretin-related Cardiac Amyloidosis

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