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Screening for amyloidosis before aortic valve elective replacement: results from the SAVER study.
Isabel Mattig1,2,3,4,5, Katrin Wrede-Wihl5,6,7, Selin Sökmen1,2,5
1Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Charitéplatz 1, Berlin 10117, Germany.
European Journal of Preventive Cardiology
|April 22, 2026
Summary
The SAVER study developed a screening tool to detect cardiac amyloidosis (CA) in patients with aortic stenosis (AS). This holistic approach identifies patients at risk, enabling earlier intervention for better outcomes.
Area of Science:
- Cardiology
- Medical Diagnostics
- Genetics
Background:
- Concomitant aortic stenosis (AS) and cardiac amyloidosis (CA) significantly worsen heart failure and reduce life expectancy.
- Early detection of CA in AS patients is crucial for preventing disease progression but remains an unmet clinical need.
Purpose of the Study:
- To establish a simple and effective screening method for cardiac amyloidosis (CA) in patients with aortic stenosis (AS).
- To identify key predictors for CA in AS patients to facilitate early diagnosis and intervention.
Main Methods:
- Prospective cohort study (SAVER) enrolling 1001 AS patients undergoing valve replacement (TAVI/SAVR).
- Initial screening included CA-specific symptoms and history, followed by DPD scintigraphy or MRI for suspected cases.
- Multiple-regression analysis identified predictors for CA risk, including male sex, carpal tunnel syndrome, spinal stenosis, and NT-proBNP.
Main Results:
- 40% of enrolled patients (405/1001) were flagged for potential CA.
- 17 cases (2%) of CA were confirmed through further diagnostics.
- The optimized screening approach achieved an AUC of 0.88, indicating high diagnostic accuracy.
Conclusions:
- The SAVER approach represents the first holistic screening method for CA in AS patients, considering multiorgan manifestations.
- This validated screening tool can be implemented in clinical practice to prevent adverse outcomes associated with combined AS and CA.
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