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Assessment of clinical characteristics of cardiac amyloidosis as a potential underlying etiology in patients diagnosed with heart failure with preserved ejection fraction

Selda Murat1, Yuksel Cavusoglu1, Halit Emre Yalvac1, Ilknur AK Sivrikoz2, Sinem Kocagil3
DOI: 10.33963/KP.a2022.0098
·
Pubmed: 35390167
Affiliations
  1. Department of Cardiology, Eskisehir Osmangazi University, Eskisehir, Turkey
  2. Department of Nuclear Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
  3. Department of Medical Genetics, Eskisehir Osmangazi University, Eskisehir, Turkey

open access

Online first
Original article
Published online: 2022-04-07

Abstract

Background: Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous clinical syndrome. Transthyretin cardiac amyloidosis (CA) is an underdiagnosed cause of HFpEF. Red flags are extremely useful for suspecting CA.

Aims: We aimed to evaluate frequency of cardiac and extracardiac clinical characteristics of CA in HFpEF patients based on red flags.

Methods: Baseline characteristics were recorded during admission. Electrocardiogram and echocardiography were performed. All patients were examined in terms of RF. Cardiac scintigraphy was performed in 85 patients.

Results: The mean (standard deviation [SD]) age of the study group was 67.9 (9.8) years, and 52 (61.2%) were female. At least 1 red flag was observed in 67% of HFpEF patients. Only 4 of the patients had more than 3 red flags. The mean number of red flags in a patient with HFpEF was 1.3. Extracardiac clinical red flags were observed in only 9 (10.5%) patients. Cardiac clinical red flags were extremely rare. An electrocardiographic red flag was detected in 2 out of 10 patients and an echocardiographic red flag in 4 out of 10 patients with HFpEF. Scintigraphy showed that 17.6% of the all patients have had a grade 2 or 3 cardiac uptake. The patients with wild-type transthyretin CA had twice as many red flags as those without.

Conclusion: The results of the study showed that; patients diagnosed with HFpEF had an average of 1.3 red flags suggestive of CA. In real life; extracardiac red flags are rare, electrocardiographic and echocardiographic red flags are more common in patients with HFpEF.

Abstract

Background: Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous clinical syndrome. Transthyretin cardiac amyloidosis (CA) is an underdiagnosed cause of HFpEF. Red flags are extremely useful for suspecting CA.

Aims: We aimed to evaluate frequency of cardiac and extracardiac clinical characteristics of CA in HFpEF patients based on red flags.

Methods: Baseline characteristics were recorded during admission. Electrocardiogram and echocardiography were performed. All patients were examined in terms of RF. Cardiac scintigraphy was performed in 85 patients.

Results: The mean (standard deviation [SD]) age of the study group was 67.9 (9.8) years, and 52 (61.2%) were female. At least 1 red flag was observed in 67% of HFpEF patients. Only 4 of the patients had more than 3 red flags. The mean number of red flags in a patient with HFpEF was 1.3. Extracardiac clinical red flags were observed in only 9 (10.5%) patients. Cardiac clinical red flags were extremely rare. An electrocardiographic red flag was detected in 2 out of 10 patients and an echocardiographic red flag in 4 out of 10 patients with HFpEF. Scintigraphy showed that 17.6% of the all patients have had a grade 2 or 3 cardiac uptake. The patients with wild-type transthyretin CA had twice as many red flags as those without.

Conclusion: The results of the study showed that; patients diagnosed with HFpEF had an average of 1.3 red flags suggestive of CA. In real life; extracardiac red flags are rare, electrocardiographic and echocardiographic red flags are more common in patients with HFpEF.

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Keywords

cardiac amyloidosis, diastolic heart failure, heart failure with preserved ejection fraction, red flags, transthyretin

About this article
Title

Assessment of clinical characteristics of cardiac amyloidosis as a potential underlying etiology in patients diagnosed with heart failure with preserved ejection fraction

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2022-04-07

Page views

184

Article views/downloads

84

DOI

10.33963/KP.a2022.0098

Pubmed

35390167

Keywords

cardiac amyloidosis
diastolic heart failure
heart failure with preserved ejection fraction
red flags
transthyretin

Authors

Selda Murat
Yuksel Cavusoglu
Halit Emre Yalvac
Ilknur AK Sivrikoz
Sinem Kocagil

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