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, and Aramburu-Bodas, Óscar
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 99mTc-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. [ABSTRACT FROM AUTHOR]