Cardiac amyloidosis: a challenging diagnosis

Morais, Graziele Cristina Palancio; Arruda, Marjorie Moreira; Bonadia, José Carlos de Aguiar; Pozzan, Geanete

doi:10.4322/acr.2014.034

Cited by 10 publications

(15 citation statements)

References 16 publications

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“…Amyloidosis is a disease characterized by deposition of amyloid protein in organs and tissues throughout the body [1][2][3]. The amyloid deposition may be organ-specific or diffuse and multisystemic; infiltrated tissue exhibits damaged function by compression and atrophy of the interstitial cells [4]. Of the more than 20 forms identified, the three most common types are amyloid light chain (AL or primary systemic), amyloid associated (AA), and amyloid beta (Ab) [1,5].…”

Section: Discussionmentioning

confidence: 99%

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Occult cardiac amyloidosis: the last chapter of a 2-year long story

Tattoli

Dell’Erba

Vella

et al. 2019

Forensic Sci Med Pathol

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Amyloidosis is characterized by deposition of insoluble fibrillar proteins in organs and tissues. The prognosis depends on where in the body amyloid deposition occurs, the amount of deposition, and the symptoms, which are often unspecific. Cardiac involvement is commonly associated with the immunoglobulin light-chain amyloidosis (AL) and may lead to sudden death. The case of a 53-year-old man's death due to unsuspected, undiagnosed AL predominantly involving the myocardium has been reported. His medical history had begun with gastroenterological symptoms. Angina pectoris and brain stroke occurred in the following years. He died after two years during the surgical implantation of a cardioverter-defibrillator because of cardiogenic shock. Post-mortem histologic examination revealed the presence of amyloid material in the lymph nodes, lungs, liver, spleen, kidneys, adrenal glands, stomach, and heart. The cause of death was cardiac failure secondary to primary systemic amyloidosis predominantly involving the heart. This case demonstrates that amyloidosis should be considered within the differential diagnoses and actively investigated in patients with unspecific and long-lasting symptoms; medical liability may also be suspected.

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Section: Discussionmentioning

confidence: 99%

“…Cardiac amyloidosis is the most common infiltrative cardiomyopathy [4,6]. AL and transthyretin amyloidosis Fig.…”

Section: Discussionmentioning

confidence: 99%

Occult cardiac amyloidosis: the last chapter of a 2-year long story

Tattoli

Dell’Erba

Vella

et al. 2019

Forensic Sci Med Pathol

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“…Shifts from Bifidobacterium to Clostridia and Bacteriodetes occur as the host develops from an infant into an adult [ 18 ]. Reductions in the level of Faecalibacterium prauznitzii and its anti-inflammatory relatives occur as young adults mature [ 6 ]. The composition of the microbiota is altered throughout the lifespan and is dependent on dietary and environmental factors, disease state, and other factors.…”

Section: The Intestinal Microbiota and Homeostasismentioning

confidence: 99%

“…The four main phyla in adults consist of Bacteroidetes (~48%) and Firmicutes (~51%), which make up the highest proportion, as well as Proteobacteria and Actinobacteria , which are found in relatively low amounts (1%) [ 4 ]. Alterations in the composition of the gut microbiota, caused by dietary changes, antibiotic exposure, and infection, lead to the loss of homeostasis, which is implicated in the development of several diseases in humans, such as colorectal cancer, metabolic syndrome, obesity, allergies, inflammatory bowel disease (IBD), type 2 diabetes, heart failure, and neurodegenerative disorders [ 5 , 6 , 7 , 8 ]. Recent evidence points to a causative link between pathogens and changes in the intestinal microbiota composition, along with inflammatory changes in various tissues and organs including brain tissue [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Gut Microbiota and Their Neuroinflammatory Implications in Alzheimer’s Disease

et al. 2018

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The bidirectional communication between the central nervous system (CNS) and the gut microbiota plays a pivotal role in human health. Increasing numbers of studies suggest that the gut microbiota can influence the brain and behavior of patients. Various metabolites secreted by the gut microbiota can affect the cognitive ability of patients diagnosed with neurodegenerative diseases. Nearly one in every ten Korean senior citizens suffers from Alzheimer’s disease (AD), the most common form of dementia. This review highlights the impact of metabolites from the gut microbiota on communication pathways between the brain and gut, as well as the neuroinflammatory roles they may have in AD patients. The objectives of this review are as follows: (1) to examine the role of the intestinal microbiota in homeostatic communication between the gut microbiota and the brain, termed the microbiota–gut–brain (MGB) axis; (2) to determine the underlying mechanisms of signal dysfunction; and (3) to assess the impact of signal dysfunction induced by the microbiota on AD. This review will aid in understanding the microbiota of elderly people and the neuroinflammatory roles they may have in AD.

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“…Presently, 36 human proteins forming amyloid and, respectively, 36 types of amyloidosis are known [2]. Some types of amyloidosis are accompanied by heart injury, amyloid cardiomyopathy [3][4][5][6]. In this case, interstitial amyloid deposits are found in the myocardium of atria and ventricles of the heart, sinoatrial and atrioventricular nodes, His bundle branches, middle and outer coat of intramural coronary arteries and veins [7,8].…”

Section: Introductionmentioning

confidence: 99%

A Novel Method for Amyloid Detection in Human Tissue Load Using a Fluorescent Dye — Congo Red Analogue

Гусельникова¹,

Antimonova²,

Федорова³

et al. 2020

Sovrem Tehnol Med

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The aim of the study was to develop a new technology for the detection of amyloid in human tissues based on the fluorescent dye, disodium salt of 2,7-(1-amino-4-sulfo-2-naphthylazo)fluorene (DSNAF). Materials and Methods. Synthesis of DSNAF was performed by diazotization of 2,7-diaminofluorene in a stream of argon followed by azo coupling with naphthionic acid. Identification of DSNAF was performed using MALDI mass spectrometry. Human myocardial samples from males and females aged from 85 to 98 years (n=11) were the material for the histochemical study. Myocardial paraffin sections were stained with a 0.1% aqueous solution of Congo red or with an aqueous solution (0.1 or 0.034%) of DSNAF under the same conditions. Results. It has been demonstrated for the first time that a new fluorene-based analogue of Congo red, DSNAF, can be successfully used to identify amyloid deposits in histological sections of human myocardium. In terms of the specificity and intensity of amyloid staining, DSNAF is comparable to Congo red, which is the gold standard for detecting amyloid deposits. The fluorescence intensity of DSNAF when binding to amyloid fibrils is significantly higher than the intensity of Congo red fluorescence (with a lower intensity of background fluorescence of heart muscle tissue). This is especially useful for identifying small deposits of amyloid in the human tissues which is important when using small biopsies. Conclusion. The advantages of using DSNAF allow us to consider the developed technology for the detection of amyloid as a new promising method of identifying amyloid deposits in human tissues.

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Cardiac amyloidosis: a challenging diagnosis

Cited by 10 publications

References 16 publications

Occult cardiac amyloidosis: the last chapter of a 2-year long story

Occult cardiac amyloidosis: the last chapter of a 2-year long story

Gut Microbiota and Their Neuroinflammatory Implications in Alzheimer’s Disease

A Novel Method for Amyloid Detection in Human Tissue Load Using a Fluorescent Dye — Congo Red Analogue

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