Title:Transthyretin Cardiac Amyloidosis and Aortic Stenosis: Connection and Therapeutic Implications
Volume: 16
Issue: 3
Author(s): Jorge Penalver*, Maxwell Ambrosino, Hee D. Jeon, Akanksha Agrawal, Napatt Kanjanahattakij, Marie Pitteloud, Jessica Stempel and Aman Amanullah
Affiliation:
- Department of Medicine, Einstein Medical Center, Philadelphia, PA 19141,United States
Keywords:
Aortic stenosis, transthyretin, cardiac amyloidosis, aortic valve replacement, left ventricular myocardium, hereditary
amyloidosis.
Abstract: Background: There is a growing interest in the observed significant incidence of
transthyretin cardiac amyloidosis in elderly patients with aortic stenosis. Approximately, 16% of
patients with severe aortic stenosis undergoing aortic valve replacement have transthyretin cardiac
amyloidosis. Outcomes after aortic valve replacement appear to be worst in patients with concomitant
transthyretin cardiac amyloidosis.
Methods: Publications in PubMed, Cochrane Library, and Embase databases were systematically
searched from January 2012 to September 2018 using the keywords transthyretin, amyloidosis, and
aortic stenosis. All studies published in English that reported the prevalence, association and outcomes
of transthyretin cardiac amyloidosis in patients with aortic stenosis undergoing were included.
Results/Conclusion: The relationship between aortic stenosis and transthyretin cardiac amyloidosis
is not well understood. A few studies have proven successful surgical management when both
conditions coexist. This systematic review suggests that transthyretin cardiac amyloidosis is
common in elderly patients with aortic stenosis and tend to have high mortality rates after AVR.
The significant incidence of the two diseases occurring simultaneously warrants further
investigation to improve management strategies in the future.
