Current Perspectives on Atrial Amyloidosis: A Narrative Review.

Area of Science:

• Cardiology
• Cardiovascular Diseases
• Amyloidosis

Background:

• Amyloidosis is a systemic disease from protein accumulation, causing organ damage.
• Cardiac amyloidosis (CA) significantly worsens patient prognosis.
• Common CA types include light-chain (AL-CA) and transthyretin amyloidosis (ATTR-CA, wild-type and hereditary).

Purpose of the Study:

• To highlight the significance of atrial involvement in cardiac amyloidosis.
• To emphasize the need for early diagnosis and effective therapeutic strategies.
• To recommend a multimodality approach for diagnosing atrial involvement in CA.

Main Methods:

• Review of existing literature on cardiac amyloidosis and atrial involvement.
• Discussion of diagnostic advancements in imaging techniques.
• Emphasis on echocardiography (standard and Doppler) and cardiac magnetic resonance (CMR).

Main Results:

• Atrial involvement in CA presents non-specifically with atrial fibrillation, diastolic dysfunction, or stroke.
• Untreated CA survival is poor (7-9 years), but treatment improves it significantly (10-24 years).
• Early detection of atrial changes can precede anatomical damage, enabling timely intervention.

Conclusions:

• Atrial involvement is common in CA but understudied.
• Early diagnosis via multimodality imaging (echocardiography, CMR) is crucial for effective treatment and improved survival.
• A comprehensive diagnostic strategy enhances patient prognosis and reduces mortality.