Management of Cardiac Amyloidosis: Do’s and Don’ts

Publication date: Available online 4 November 2019Source: Canadian Journal of CardiologyAuthor(s): Kevin M. Alexander, Ronald M. WittelesAbstractCardiac amyloidosis is a potentially deadly disease characterized by progressive infiltration of amyloid fibrils, and is increasingly recognized as an underdiagnosed but important cause of heart failure. Given its unique pathogenesis, there are key differences in the management of cardiac amyloidosis compared to other forms of heart failure. Moreover, the two common forms of cardiac amyloidosis, transthyretin and light chain amyloidosis, are distinct entities with varying clinical manifestations and prognoses, leading to the need for tailored approaches for managing these individual diseases. In the past decade, there have been many significant advances in the diagnosis and treatment of both forms of cardiac amyloidosis. For instance, in select cases, transthyretin cardiac amyloidosis can be diagnosed non-invasively with bone scintigraphy imaging, avoiding the need for a biopsy. Effective, more targeted therapies have been developed for both transthyretin and light chain amyloidosis. However, these treatments are much more efficacious in early stages of disease before significant end-organ amyloid deposition has occurred. Consequently, it is increasingly imperative that clinicians aggressively screen at-risk groups, identify early signs of disease, and initiate treatment. Finally, once thought to be ill-advised, heart transplantation...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research