The Importance of the DEIC/GEMIC/SBC 2021 Position Statement on Diagnosis and Treatment of Cardiac Amyloidosis to Clinical Practice

Cardiac amyloidosis is a frequent cause of heart failure with preserved ejection fraction

The main cardiological phenotype of CA is that of an infiltrative restrictive cardiomyopathy, whose more general aspects of symptoms, increased thickness of the ventricular walls, and concentric remodeling of the left ventricle, overlap with those of heart failure with preserved ejection fraction (HFpEF), produced by risk factors such as high blood pressure, obesity, diabetes, and aging. Thus, CA should be considered as a differential diagnosis in patients who exhibit HFpEF.

It is worth remembering that, among the different amyloidogenic proteins that can be deposited in the myocardium and cause CA, the wild type transthyretin form (ATTR-CAwt), which is closely linked to aging, is the most frequently reported in several series of specialized medical literature. This has been repeated both in large reference centers and in real world registers. Accordingly, a recent article has shown a very significant increase in CA as a cause of hospitalizations due to heart failure in several regions of the United States, between 2000 and 2012, exceeding the rate of 65 cases per 100,000 people/year, indicating that CA is not a rare disease according to the current criteria of the World Health Organization ( ).

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