Mesquita ET, Jorge AJL, Souza CV, Andrade TRD. Cardiac Amyloidosis and its New Clinical Phenotype: Heart Failure with Preserved Ejection Fraction.
Arq Bras Cardiol 2017;
109:71-80. [PMID:
28678923 PMCID:
PMC5524478 DOI:
10.5935/abc.20170079]
[Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 03/09/2017] [Indexed: 12/24/2022] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) is now an emerging
cardiovascular epidemic, being identified as the main phenotype observed in
clinical practice. It is more associated with female gender, advanced age and
comorbidities such as hypertension, diabetes, obesity and chronic kidney
disease. Amyloidosis is a clinical disorder characterized by the deposition of
aggregates of insoluble fibrils originating from proteins that exhibit anomalous
folding. Recently, pictures of senile amyloidosis have been described in
patients with HFpEF, demonstrating the need for clinical cardiologists to
investigate this etiology in suspect cases. The clinical suspicion of
amyloidosis should be increased in cases of HFPS where the cardio imaging
methods are compatible with infiltrative cardiomyopathy. Advances in cardio
imaging methods combined with the possibility of performing genetic tests and
identification of the type of amyloid material allow the diagnosis to be made.
The management of the diagnosed patients can be done in partnership with centers
specialized in the study of amyloidosis, which, together with the new
technologies, investigate the possibility of organ or bone marrow
transplantation and also the involvement of patients in clinical studies that
evaluate the action of the new emerging drugs.
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