Cardiac amyloidosis – an underestimated etiology for heart failure with preserved ejection fraction. A literary review

Abstract

Cardiac amyloidosis, once considered a rare disease, is a severe and progressive cardiomyopathy characterized by extracellular deposition of misfolded proteins in the ventricular myocardium. Early diagnosis of cardiac amyloidosis is essential for improving patient prognosis, as it allows for a broader range of therapeutic options that can enhance outcomes and/or prevent potentially irreversible loss of physical function and quality of life. Current data suggest that a majority of patients do not get a timely diagnosis. Patients with early-stage CA do not exhibit reduced global left ventricular systolic function but may develop symptoms of heart failure with preserved ejection fraction (HFpEF), with CA considered as one of the overlooked etiologies of HFpEF in the elderly. Cardiac amyloidosis is a progressive disease with a poor prognosis if left untreated. The average life expectancy of untreated patients with AL cardiac amyloidosis is less than 6 months, while that of patients with ATTR-CA is 2.5-3.5 years. Therefore, early clinical identifi cation is essential.

Keywords

• cardiac amyloidosis
• monoclonal immunoglobulin lig