Prevalence of Cardiac Amyloidosis in Patients with Carpal Tunnel Syndrome

Zegri-Reiriz, Isabel; Moral, F. Javier de Haro-del; Domínguez, Fernándo; Salas, Clara; Cuadra, Pablo de la; Plaza, Aresio; Krsnik, Isabel; González-López, Esther; García‐Pavía, Pablo

doi:10.1007/s12265-019-09895-0

Cited by 42 publications

(45 citation statements)

References 17 publications

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“…3d) [10,31,41,44]. In studies that reported on survival and mortality [6,10,24,35,37,38,40,41,[45][46][47], these outcomes did not appear to be different between women and men. Multiple approaches can be taken to establish a diagnosis of ATTR-CM, including endomyocardial or extracardiac biopsy, mass spectrometry, and nuclear scintigraphy; in addition, DNA genotyping can be used to confirm the presence or absence of a TTR gene mutation after the diagnosis is established [18].…”

Section: Sex-related Differences In Demographic and Clinical Charactementioning

confidence: 93%

“…Supplementary Tables 4-6) [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. However, some anatomical differences in cardiac structure were identified (Fig.…”

Section: Sex-related Differences In Demographic and Clinical Charactementioning

confidence: 99%

“…The most common were cardiac biopsy [6, 10, 24-26, 28, 31-39, 41, 43, 44, 46, 47, 49-54], DNA genotyping [6, 10, 25, 27-30, 33, 37, 40-45, 47, 48, 51-53, 55-58], and extracardiac biopsy, performed in 26 (68%), 24 (63%), and 19 (50%) studies, respectively. Biopsy was not performed in 6 (16%) studies [27,29,30,40,55,57], but DNA genotyping was conducted in all 6 of these studies and nuclear scintigraphy in 2 of the 6 studies. Cardiac and extracardiac biopsies were conducted together in 14 (37%) [6,10,26,28,33,39,41,44,46,[51][52][53][54] studies, and cardiac biopsy and DNA genotyping were conducted together in 13 (34%) studies [6,10,25,28,33,37,41,43,44,47,[51][52][53].…”

Section: Sex-related Differences In Demographic and Clinical Charactementioning

confidence: 99%

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Transthyretin amyloid cardiomyopathy in women: frequency, characteristics, and diagnostic challenges

et al. 2020

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Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive, life-threatening disease characterized by deposition of insoluble amyloid fibrils in the myocardium, resulting in cardiac structural and functional abnormalities and ultimately heart failure. Disease frequency is reportedly lower in women than men, but sex-related differences have not been well established. We conducted a systematic literature review (SLR), based on PRISMA-P guidelines and registered with PROSPERO, to assess whether the epidemiology and clinical presentation of ATTR-CM differ between women and men. MEDLINE, Embase, and Cochrane databases and selected conference proceedings were searched (August 16, 2019) to identify observational and clinical studies reporting sex-specific data for patients with wild-type or hereditary ATTR-CM. Of 193 publications satisfying final eligibility criteria, 69 studies were included in our pooled analysis. Among the 4669 patients with ATTR-CM analyzed, 791 (17%) were women, including 174 (9%), 366 (29%), and 251 (18%) in studies of wild-type, hereditary, and undefined ATTR-CM, respectively. Data available on disease characteristics were limited and very heterogeneous, but trends suggested some cardiac structural/functional differences, i.e., lower interventricular septal and posterior wall thickness and left ventricular (LV) end diastolic diameter, and higher LV ejection fractions, in women versus men across ATTR-CM subtypes. Because LV wall thickness > 12 mm is generally the suggested threshold for ATTR-CM diagnosis in both sexes, smaller cardiac anatomy in women with the disease may lead to underdiagnosis. Additional research and studies are needed to elucidate potential disparities between sexes in ATTR-CM frequency, clinical characteristics, and underlying biological mechanisms. This study was registered within the International Prospective Register of Systematic Reviews (PROSPERO) database of the University of York (CRD42019146995).

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Section: Sex-related Differences In Demographic and Clinical Charactementioning

confidence: 93%

“…Supplementary Tables 4-6) [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. However, some anatomical differences in cardiac structure were identified (Fig.…”

Section: Sex-related Differences In Demographic and Clinical Charactementioning

confidence: 99%

Section: Sex-related Differences In Demographic and Clinical Charactementioning

confidence: 99%

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Transthyretin amyloid cardiomyopathy in women: frequency, characteristics, and diagnostic challenges

et al. 2020

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“…However, criteria and optimal timing for potential screening for CA in CTS patients are yet to be established. Exploring this, Zegri-Reiriz et al 10 recently examined 233 patients ≥60 years of age with previous CTS surgery from 2005 to 2014 and found an overall 1.2% prevalence of CA, somewhat lower than expected. Of importance is that the cohort was mainly female, possibly diminishing the yield of CA as the gender ratio of CTS in the context of ATTR is reversed, as pointed out by Milandri et al When only including patients with bilateral CTS, left ventricular hypertrophy and no occupational risk factors for CTS, the prevalence of CA in CTS patients rose to 13.6%.…”

Section: This Article Refers To 'Carpal Tunnel Syndrome In Cardiac Ammentioning

confidence: 94%

“…However, criteria and optimal timing for potential screening for CA in CTS patients are yet to be established. Exploring this, Zegri‐Reiriz et al . recently examined 233 patients ≥60 years of age with previous CTS surgery from 2005 to 2014 and found an overall 1.2% prevalence of CA, somewhat lower than expected.…”

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confidence: 94%

Refining the role of carpal tunnel syndrome in cardiac amyloidosis

Westin

Fosbøl

Gustafsson

2020

European J of Heart Fail

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Prognostic significance of unexplained left ventricular hypertrophy in patients undergoing carpal tunnel surgery

et al. 2021

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Aims Carpal tunnel (CT) syndrome is a recognized red‐flag of cardiac amyloidosis (CA) and increased cardiovascular (CV) morbidity. We designed this study to characterize the CV profile of patients with CT syndrome at the time of first surgery and to identify high‐risk presentations. Methods and results We retrospectively reviewed 643 patients who underwent CT surgery between 2007 and 2019. Of them, 130 patients (77 years, 45% male patients, left ventricular ejection fraction 62%) with available CV characterization within ±12 months from CT surgery were included. Abnormal loading conditions causing cardiac left ventricular hypertrophy (LVH) were investigated to distinguish explained LVH (Ex‐LVH) from unexplained LVH (Un‐LVH). LVH was found in 66 (51%) patients, 33% of them presented Un‐LVH. Compared with the others, Un‐LVH patients were older (77 and 75 vs. 70 years in Un‐LVH, Ex‐LVH, and non‐LVH, respectively; P = 0.002), had higher rates of electrocardiogram‐echo discrepancy (70%, 14.3%, and 1.6%, respectively; P < 0.001) and of echocardiographic findings of CA (24%, 7%, and 0%, P < 0.001). Among Un‐LVH patients, 9 (43%) experienced death and 7 (33%) developed heart failure (HF) at 3.8 and 2.4 years from CT surgery, respectively. Compared with the others, death and HF development rates were higher in Un‐LVH patients both at unadjusted (P = 0.01 and P = 0.02, respectively) and adjusted analysis for age, gender, and renal insufficiency (P = 0.00038 and P = 0.050, respectively). Conclusions At the time of CT surgery, Un‐LVH was found in more than 30% of patients with LVH, and 24% of them showed echocardiographic features suggesting an underdiagnosed CA. Un‐LVH was associated with higher all‐cause mortality and HF development.

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Prevalence of Cardiac Amyloidosis in Patients with Carpal Tunnel Syndrome

Cited by 42 publications

References 17 publications

Transthyretin amyloid cardiomyopathy in women: frequency, characteristics, and diagnostic challenges

Transthyretin amyloid cardiomyopathy in women: frequency, characteristics, and diagnostic challenges

Refining the role of carpal tunnel syndrome in cardiac amyloidosis

Prognostic significance of unexplained left ventricular hypertrophy in patients undergoing carpal tunnel surgery

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