Prevalence of Transthyretin Amyloid cardiomyopathy in patients hospitalized for heart failure with preserved ejection fraction in an Argentine center.

SANTIAGO DECOTTO; DIEGO PEREZ DE ARENAZA; MARIA LOURDES POSADAS MARTINEZ

Simposio; International Symposium on Amyloidosis 2024; 2024

ID 411Prevalence of Transthyretin Amyloid cardiomyopathy in patients hospitalized for heart failure with preserved ejection fraction in an Argentine center.Authors: Santiago Decotto,Gonzalo Fernández Villar,Eugenia Villanueva,MARIA LOURDES POSADAS MARTINEZ,MARIA ADELA AGUIRRE,Diego Perez de Arenaza,Luciano Lucas,Santiago Del Castillo,Emiliano Rossi,Cesar Belziti,Rodolfo PizarroKeywords: Transthyretin Amyloid cardiomyopathy, Heart failure, preserved ejection fractionBackground: Transthyretin Amyloid cardiomyopathy (ATTR-CM) usually presents as heart failure with preserved ejection fraction (HFpEF). Its diagnosis has a significant clinical impact, as specific treatment is currently available.Objective: To assess the prevalence of ATTR-CM in patients hospitalized for HFpEF and increased septal thickness in our institution.Methods: Cross-sectional study. Patients hospitalized for HFpEF (>50%) and septal thickness ≥ 12 mm during the period from 8/2019 to 1/2023 were prospectively included. Patients with pacemaker, significant left valve disease and end-stage renal failure (creatinine clearance < 30 ml/min/BSA) were excluded. A pyrophosphate bone scintigraphy (PYP) was planned to be performed in order to assess ATTR-CM. The prevalence of ATTR-CM and its 95% confidence interval were calculated.Results: A PYP was performed in 59/82 patients hospitalized for HFpEF. Median age was 85 [IQR 78-88] years, and 54% were women. At admission, 61% (n=36) had atrial fibrillation and the median NT Pro-Bnp was 3536 [1700-7748] pg/nl. The mean left ventricle ejection fraction was 57% (+/- 5%). The prevalence of ATTR-CM diagnosed by PYP was 19% (95% CI 9.7-30.1, n=11). There were no significant clinical differences between patients who performed a PYP and did not. Patients with ATTR-CM had lower blood pressure and higher septal thickness, NT Pro-Bnp and troponin levels compared to patients without ATTR-CM (TABLE).Conclusion: In patients admitted for HFpEF and increased septal thickness, the diagnosis of ATTR-CM was relatively common (1/5). We believe that it should be routinely explored.