What’s New in Cardiac Amyloidosis?

Abstract

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Amyloidosis is characterized by the localized or systemic deposition of proteins with unstable tertiary structure, which aggregate and form amyloid fibrils. Cardiac amyloidosis is a frequently underdiagnosed condition and it is an important cause of heart failure. There are more than 30 known types of amyloid proteins, but only five often infiltrate the heart, causing cardiac amyloidosis. light chain immunoglobulin, heavy chain immunoglobulin, transthyretin, serum amyloid A and apolipoprotein AI, mostly in light chain immunoglobulin or transthyretin forms. According to the type of fibrillar protein deposited, cardiac amyloidosis has different clinical courses, prognosis and different forms of treatment. In this review, we address new techniques that allow the diagnosis of this entity, especially in situations of heart failure with preserved ejection fraction and restrictive heart diseases. Early diagnosis is fundamental in defining the best therapeutic approach and in the prognosis of these patients.