Related Experiment Video
Updated: Oct 10, 2025
Performing and Processing FNA of Anterior Fat Pad for Amyloid
Published on: October 30, 2010
Incidence and Characterization of Concealed Cardiac Amyloidosis Among Unselected Elderly Patients Undergoing
Aldostefano Porcari1, Rossana Bussani2, Marco Merlo1
1Cardiovascular Department, Center for Diagnosis and Treatment of Cardiomyopathies, Azienda Sanitaria Universitaria Giuliano-Isontina, University of Trieste, Trieste, Italy.
Insights
Cardiac amyloidosis (CA) affects 43% of older adults, often presenting with heart failure and atrial fibrillation. Early detection through specific red-flags is crucial for managing this common condition.
Area of Science:
- Cardiology
- Pathology
- Geriatrics
Background:
- The prevalence of cardiac amyloidosis (CA) remains largely unknown in the general elderly population.
- Understanding CA prevalence is critical for diagnosing and managing heart conditions in older adults.
Purpose of the Study:
- To determine the prevalence of cardiac amyloidosis in unselected patients aged 75 years and older undergoing autopsy.
- To characterize the cardiological profiles of patients with and without CA, correlating clinical findings with histological data.
- To compare the cardiological profiles between CA and non-CA patient groups.
Main Methods:
- Autopsy analysis of hearts from patients ≥75 years old, with dedicated staining for amyloid deposition.
- Assessment of amyloid localization (interstitial, vascular) and distribution (non-diffuse, diffuse).
- Retrospective review of cardiological data, including echocardiographic red-flags, for clinical-histological correlation.
Main Results:
- Cardiac amyloidosis was identified in 43% of autopsied hearts, with equal prevalence of light chain and transthyretin types.
- Atrial involvement was nearly universal (96%), with amyloid deposition in both interstitial and perivascular spaces.
- CA patients exhibited significantly higher rates of heart failure, atrial fibrillation, left ventricular hypertrophy, and restrictive filling patterns compared to non-CA patients.
Conclusions:
- Cardiac amyloidosis is highly prevalent (43%) in autopsy series of patients ≥75 years old.
- Heart failure, left ventricular hypertrophy, and atrial fibrillation are key clinical indicators associated with CA.
- Echocardiographic red-flags can suggest CA, highlighting the need for increased awareness and diagnostic consideration in elderly patients.
Abstract:
Background: The prevalence of cardiac amyloidosis (CA) is unknown. Aims and Methods: We sought to (a) determine the prevalence of CA in unselected patients ≥75 years undergoing autopsy, (b) characterize cardiological profiles of CA and non-CA patients by providing clinical-histological correlations, and (c) compare their cardiological profiles. After dedicated staining, the localization (interstitial or vascular) and the distribution (non-diffuse or diffuse) of amyloid deposition were analyzed. Cardiological data at last evaluation were retrospectively assessed for the presence of CA red-flags. Results: CA (50% light chains, 50% transthyretin) was found in 43% (n = 24/56) of the autopsied hearts. Atria were involved in 96% of cases. Amyloid localized both at the perivascular and interstitial levels (95.5 and 85%, respectively) with a slightly predominant non-diffuse distribution (58% of cases). Compared to the other patients, CA patients had a more frequent history of heart failure (HF) (79 vs. 47%, p = 0.014), advanced NYHA functional class (III-IV 25 vs. 6%, p = 0.047), atrial fibrillation (68 vs. 36%, p = 0.019), discrepancy between QRS voltage and left ventricular (LV) thickness (70 vs. 12%, p < 0.001), thicker LV walls (15 vs. 11 mm, p < 0.001), enlarged left atrium (49 vs. 42 mm, p = 0.019) and restrictive filling pattern (56 vs. 19%, p = 0.020). The presence of right ventricular amyloidosis seemed to identify hearts with a higher amyloid burden. Among the CA patients, >30% had ≥3 echocardiographic red-flags of disease. Conclusion: CA can be found in 43% of autopsied hearts from patients ≥75 years old, especially in patients with HF, LV hypertrophy and atrial fibrillation.
More Related Videos
10:04Imaging Amyloid Tissues Stained with Luminescent Conjugated Oligothiophenes by Hyperspectral Confocal Microscopy and Fluorescence Lifetime Imaging
Published on: October 20, 2017
09:31Visualization of Amyloid β Deposits in the Human Brain with Matrix-assisted Laser Desorption/Ionization Imaging Mass Spectrometry
Published on: March 7, 2019
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:30Coronary Artery Disease III: Clinical Manifestations
01:28Imaging Studies for Cardiovascular System V: CT
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy