Estimating the Prevalence of Cardiac Amyloidosis in Old Patients with Heart Failure—Barriers and Opportunities for Improvement: The PREVAMIC Study

Background: Cardiac amyloidosis (CA) could be a common cause of heart failure (HF). The objective of the study was to estimate the prevalence of CA in patients with HF. Methods: Observational, prospective, and multicenter study involving 30 Spanish hospitals. A total of 453 patients ≥ 65 years with...

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Detalles Bibliográficos
Autores: Ruiz-Hueso, Rocío, Salamanca-Bautista, Prado, Quesada-Simón, Maria Angustias, Yun, Sergi, Conde-Martel, Alicia, Morales Rull, José Luis, Suárez-Gil, Roi, García-García, José Ángel, Llàcer, Pau, Fonseca-Aizpuru, Eva María, Amores-Arriaga, Beatriz, Martínez-González, Ángel, Armengou-Arxe, Arola, Peña-Somovilla, José Luis, López-Reboiro, Manuel Lorenzo, Aramburu-Bodas, Óscar, PREVAMIC Investigators Group
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10459.1/464341
Acceso en línea:https://doi.org/10.3390/jcm12062273
https://hdl.handle.net/10459.1/464341
Access Level:acceso abierto
Palabra clave:Cardiac amyloidosis
Epidemiology
Heart failure
Prevalence
Descripción
Sumario:Background: Cardiac amyloidosis (CA) could be a common cause of heart failure (HF). The objective of the study was to estimate the prevalence of CA in patients with HF. Methods: Observational, prospective, and multicenter study involving 30 Spanish hospitals. A total of 453 patients ≥ 65 years with HF and an interventricular septum or posterior wall thickness > 12 mm were included. All patients underwent a 99mTc-DPD/PYP/HMDP scintigraphy and monoclonal bands were studied, following the current criteria for non-invasive diagnosis. In inconclusive cases, biopsies were performed. Results: The vast majority of CA were diagnosed non-invasively. The prevalence was 20.1%. Most of the CA were transthyretin (ATTR-CM, 84.6%), with a minority of cardiac light-chain amyloidosis (AL-CM, 2.2%). The remaining (13.2%) was untyped. The prevalence was significantly higher in men (60.1% vs 39.9%, p = 0.019). Of the patients with CA, 26.5% had a left ventricular ejection fraction less than 50%. Conclusions: CA was the cause of HF in one out of five patients and should be screened in the elderly with HF and myocardial thickening, regardless of sex and LVEF. Few transthyretin-gene-sequencing studies were performed in older patients. In many patients, it was not possible to determine the amyloid subtype.

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