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 w...

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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:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/200879
Acceso en línea:https://hdl.handle.net/2445/200879
Access Level:acceso abierto
Palabra clave:Amiloïdosi
Insuficiència cardíaca
Epidemiologia
Amyloidosis
Heart failure
Epidemiology
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 Tc-99m-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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