Prevalence of moderate-severe aortic stenosis in patients with wild-type transthyretin amyloidosis in a developing country.

SANTAIGO DE COTTO; DIEGO PEREZ DE ARENAZA; MARIA LOURDES POSADAS MARTINEZ

Simposio; International Symposium on Amyloidosis 2024; 2024

ID 403Background: Recent studies suggest that the coexistence of aortic stenosis (AS) and wild-type transthyretin amyloidosis (ATTRwt) is more common than previously anticipated. Data regarding this coexistence in our region is lacking.Objective: To describe the prevalence of moderate-severe AS in patients with ATTRwt amyloidosis and the clinical features, echocardiographic characteristics, and clinical course of these patients. Moderate-severe AS was defined by an aortic valve area of < 1.5 cm2.Methods: Retrospective cohort including patients with ATTRwt amyloidosis from the Hospital Italiano de Buenos Aires Institutional Amyloidosis Registry, from November 2007 to May 2021. The prevalence of moderate-severe AS was estimated and presented as a percentage with its 95% CI. Clinical characteristics were compared by groups according to whether or not they had moderate-severe AS.Results: 104 patients with ATTRwt amyloidosis were included. The median age was 82 [77 - 88] years, 89% were male. At the time of ATTRwt amyloidosis diagnosis, 10.5% (n=11, CI 5-18%) of patients had moderate-severe AS. Patients with AS were older (p=0.05) and had numerically higher NT-ProBnp values and numerically lower ejection fraction with non-statistically significant differences compared with patients without AS (TABLE). Most of the patients were subclassified as low flow-low gradient severe AS (n=7). During a median follow-up of 476 days, 4 patients underwent an aortic valve intervention, 5 were hospitalized for heart failure and 4 died.Conclusions: In our cohort, the prevalence of the coexistence of both pathologies was 10%. Low flow-low gradient severe AS was the most frequent subgroup of AS.