2018, Number 1
<< Back Next >>
Acta Med 2018; 16 (1)
Senil amyloidosis
Harrison GC, Harrison RD, Guerrero GH, Sánchez LF
Language: Spanish
References: 15
Page: 58-62
PDF size: 259.74 Kb.
ABSTRACT
Background: Heart failure with preserved ejection fraction (HFPEF) in the elderly is common, at least 50% of cases of heart failure in the elderly belong to this category. Often these patients have other comorbidities as: systemic hypertension, diabetes or ischemic heart disease that can partially explain the diastolic dysfunction; at least 25% autopsy studies discloses amyloid deposits in hearts of octogenarians, often without clinical relevance. Usually physicians do not think on amyloidosis as etiologic factor and probably it is underdiagnosed because of difficulties making histologic diagnosis based on endomyocardial biopsies.
Case report: A patient with HFPEF and cardiac senile amyloidosis is described, different modalities for making non-invasive/non biopsy diagnosis of transthyretin amyloidosis (ATTR) are discussed.
Conclusion: Cardiac senile amyloidosis is probably a not so uncommon cause of HFPEF.
REFERENCES
Tanskanen M, Peuralinna T, Polvikoski T, Notkola IL, Sulkava R, Hardy J et al. Senile systemic amyloidosis affects 25% of the very aged and associates with genetic variations in alpha 2-macroglobulin and tau: a population-based autopsy study. Ann Med. 2008; 40 (3): 232-239.
Falk RH. Cardiac amyloidosis, a treatable disease, often overlooked. Circulation. 2011; 124 (9): 1079-1085.
Selvanayagam JB, Hawkins PN, Paul B, Myerson SG, Neubauer S. Evaluation and management of the cardiac amyloidosis. J Am Coll Cardiol. 2007; 50 (22): 2101-2110.
Seward JB, Casaclang-Verzosa. Infiltrative cardiovascular disease: cardiomyopathies that look alike. J Am Coll Cardiol. 2010; 55 (17): 1769-1779.
Fontana M, Pica S, Reant P, Abdel-Gadir A, Treibel TA, Banypersad SM et al. Prognostic value of late gadolinium enhancement cardiovascular magnetic resonance in cardiac amyloidosis. Circulation. 2015; 132 (6): 1570-1579.
Dungu JN, Valencia O, Pinney JH, Gibbs SD, Rowczenio D, Gilbertson JA et al. Dungu JN, Valencia O, Pinney JH et al. CMR-based differentiation of AL and ATTR cardiac amyloidosis. JACC Cardiovasc Imaging. 2014; 7 (2): 133-142.
Di Bella G, Pizzino F, Minutoli F, Zito C, Donato R, Dattilo G et al. The mosaic of the cardiac amyloidosis diagnosis: role of imagen in subtypes and stages of the disease. Eur Heart J Cardiovasc Imaging. 2014; 15 (12): 1307-1315.
Arbustini E, Merlini G. Early identification of transthyretin-related hereditary cardiac amyloidosis. JACC Cardiovasc Imaging. 2014; 7 (5): 511-514.
Ruberg FL, Berk JL. Transthyretin cardiac amyloidosis. Circulation. 2012; 126 (10): 1286-1300.
Perugini E, Guidalotti PL, Salvi F, Cooke RM, Pettinato C, Riva L et al. Noninvasive etiologic diagnosis of cardiac amyloidosis using 99mTc-diphosphono-1,2-propanodicarboxylic acid scintigraphy. J Am Coll Cardiol. 2005; 46 (6): 1076-1084.
Gillmore JD, Maurer MS, Falk RH, Merlini G, Damy T, Dispenzieri A et al. Nonbiopsy diagnosis of cardiac transthyretin amyloidosis. Circulation. 2016; 133 (24): 2404-2412.
Pfeffer AM, Branwald E. Treatment of heart failure with preserved ejection fraction: Reflections on its treatment with an aldosterone antagonist. JAMA Cardiol. 2016; 1 (1): 7-8.
Butler J, Hamo CE, Udelson JE, Pitt B, Yancy C, Shah SJ et al. Exploring new endpoints for patients with heart failure with preserved ejection fraction. Circ Heart Fail. 2016; 9 (11): pii: e003358.
Palau P, Núñez E, Domínguez E, Sanchis J, Núñez J. Physical therapy in heart failure with preserved ejection fraction: A systematic review. Eur J Prev Cardiol. 2016; 23: 4-13.
Sant’Anna R, Gallego P, Robinson LZ, Pereira-Henriques A, Ferreira N, Pinheiro F et al. Repositioning tolcapone as a potent inhibitor of transthyretin amiloidogenesis and assiacited celular toxicity. Nat Commun. . 2016; 7: 10787. doi: 10.1038/NCOMMS10787.