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Current Heart Failure Reports

Erschienen in:

28.11.2019 | Comorbidities of Heart Failure (C Angermann, Section Editor)

Amyloidosis in Heart Failure

verfasst von: Sandra Ihne, Caroline Morbach, Laura Obici, Giovanni Palladini, Stefan Störk

Erschienen in: Current Heart Failure Reports | Ausgabe 6/2019

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Abstract

Purpose

Amyloidosis represents an increasingly recognized but still frequently missed cause of heart failure. In the light of many effective therapies for light chain (AL) amyloidosis and promising new treatment options for transthyretin (ATTR) amyloidosis, awareness among caregivers needs to be raised to screen for amyloidosis as an important and potentially treatable differential diagnosis. This review outlines the diversity of cardiac amyloidosis, its relation to heart failure, the diagnostic algorithm, and therapeutic considerations that should be applied depending on the underlying type of amyloidosis.

Recent Findings

Non-biopsy diagnosis is feasible in ATTR amyloidosis in the absence of a monoclonal component resulting in higher detection rates of cardiac ATTR amyloidosis. Biomarker-guided staging systems have been updated to facilitate risk stratification according to currently available biomarkers independent of regional differences, but have not yet prospectively been tested. Novel therapies for hereditary and wild-type ATTR amyloidosis are increasingly available. The complex treatment options for AL amyloidosis are improving continuously, resulting in better survival and quality of life. Mortality in advanced cardiac amyloidosis remains high, underlining the importance of early diagnosis and treatment initiation.

Summary

Cardiac amyloidosis is characterized by etiologic and clinical heterogeneity resulting in a frequently delayed diagnosis and an inappropriately high mortality risk. New treatment options for this hitherto partially untreatable condition have become and will become available, but raise challenges regarding their implementation. Referral to specialized centers providing access to extensive and targeted diagnostic investigations and treatment initiation may help to face these challenges.

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Titel: Amyloidosis in Heart Failure
verfasst von: Sandra Ihne
Caroline Morbach
Laura Obici
Giovanni Palladini
Stefan Störk
Publikationsdatum: 28.11.2019
Verlag: Springer US
Erschienen in: Current Heart Failure Reports / Ausgabe 6/2019
Print ISSN: 1546-9530
Elektronische ISSN: 1546-9549
DOI: https://doi.org/10.1007/s11897-019-00446-x

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Abstract

Purpose

Recent Findings

Summary

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