Valve disease in cardiac amyloidosis: an echocardiographic score

Aimo, Alberto; Fabiani, Iacopo; Maccarana, Agnese; Vergaro, Giuseppe; Chubuchny, Vladyslav; Pasanisi, Emilio; Petersen, C.; Poggianti, Elisa; Giannoni, Alberto; Spini, Valentina; Taddei, C; Castiglione, Vincenzo; Passino, Claudio; Fontana, Marianna; Emdin, Michele; Venneri, Lucia

doi:10.1007/s10554-023-02901-2

Cited by 6 publications

(1 citation statement)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Echocardiographic scores based on valvular characteristics have demonstrated reasonable diagnostic performance to differentiate ATTR- from AL-CA and ATTR-CA from their matched controls. 45 However, CA is an infiltrative disorder that impacts all the chambers of the heart. Therefore, a thorough echocardiographic assessment is likely to enhance clinical suspicion and diagnostic accuracy.…”

Section: Diagnosis Of Amyloidosis In the Setting Of Aortic Stenosismentioning

confidence: 99%

Cardiac amyloidosis and aortic stenosis: a state-of-the-art review

Jaiswal,

Agrawal,

Khulbe

et al. 2023

European Heart Journal Open

View full text Add to dashboard Cite

Cardiac amyloidosis is caused by the extracellular deposition of amyloid fibrils in the heart, involving not only the myocardium but any cardiovascular structure. Indeed, this progressive infiltrative disease also involves the cardiac valves and, specifically, shows a high prevalence with aortic stenosis. Misfolded proteins infiltration in the aortic valve leads to tissue damage resulting in the onset or worsening of valve stenosis. Transthyretin-cardiac amyloidosis and aortic stenosis coexist in patients > 65 years in about 4 to 16% of cases, especially in those undergoing transcatheter aortic valve replacement. Diagnostic work-up for cardiac amyloidosis in patients with aortic stenosis is based on a multiparametric approach considering clinical assessment, electrocardiogram, haematologic tests, basic and advanced echocardiography, cardiac magnetic resonance, technetium labeled cardiac scintigraphy like 99mTc-pyrophosphate, 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid, and 99mTc-hydroxymethylenediphosphonate. However, a biopsy is the traditional gold standard for diagnosis. The prognosis of patients with coexisting cardiac amyloidosis and aortic stenosis is still under evaluation. The combination of these two pathologies worsens the prognosis. Regarding treatment, mortality is reduced in patients with cardiac amyloidosis and severe aortic stenosis after undergoing transcatheter aortic valve replacement. Further studies are needed to confirm these findings and to understand whether the diagnosis of cardiac amyloidosis could affect therapeutic strategies. The aim of this review is to critically expose the current state-of-art regarding the association of cardiac amyloidosis with aortic stenosis, from pathophysiology to treatment.

show abstract

Section: Diagnosis Of Amyloidosis In the Setting Of Aortic Stenosismentioning

confidence: 99%

Cardiac amyloidosis and aortic stenosis: a state-of-the-art review

Jaiswal,

Agrawal,

Khulbe

et al. 2023

European Heart Journal Open

View full text Add to dashboard Cite

show abstract

Early detection of subclinical cardiac amyloidosis: the importance of increasing physician awareness and routine imaging assessment

Gräni

2024

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

show abstract

Valvular heart disease in patients with cardiac amyloidosis

Aimo,

Camerini,

Fabiani

et al. 2023

Heart Fail Rev

View full text Add to dashboard Cite

Cardiac amyloidosis (CA) is an underdiagnosed condition caused by the deposition of misfolded proteins, namely immunoglobulin light chains and transthyretin, in the extracellular spaces of the heart. Any cardiovascular structure can be affected by amyloid infiltration, including the valves. Amyloid accumulation within the cardiac valves may lead to their structural and functional impairment, with a profound impact on patients’ prognosis and quality of life. The most common forms of valvular disease in CA are aortic stenosis (AS), mitral regurgitation (MR), and tricuspid regurgitation (TR). CA and AS share similar risk factors, disease mechanisms, and remodeling patterns, which make their diagnosis particularly challenging. Patients with both CA and AS experience worse outcomes than CA or AS alone, and transcatheter aortic valve replacement may represent a useful therapeutic strategy in this population. Data on MR and TR are quite limited and mainly coming from case reports or small series. This review paper will summarize our current understanding on the epidemiology, disease mechanisms, echocardiographic features, clinical implications, and therapeutic options of AS, MR, and TR in patients with CA.

show abstract

Valve disease in cardiac amyloidosis: an echocardiographic score

Cited by 6 publications

References 23 publications

Cardiac amyloidosis and aortic stenosis: a state-of-the-art review

Cardiac amyloidosis and aortic stenosis: a state-of-the-art review

Early detection of subclinical cardiac amyloidosis: the importance of increasing physician awareness and routine imaging assessment

Valvular heart disease in patients with cardiac amyloidosis

Contact Info

Product

Resources

About