Researchers carried out a new multi-cohort study to understand the influence of wild-type transthyretin cardiac amyloidosis (ATTR) on aortic stenosis (AS) on AS-ATTR,.They analysed the myocardial stress, damage, function and structure by assessing the afterload-related and amyloid-related as well as age-related remodeling on the new AS-ATTR phenotype.

583 patients were included in the study and divided into 4 sample groups for comparison. 359 patients with AS, 107 with ATTR, 36 with AS-ATTR and a control group of 81 participants who were matched for age and ethnicity. For the diagnosis of amyloidosis, (Perugini grade 1 was excluded). 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) scintigraphy was used for the grading. NT-pro Brain Natriuretic Peptide (BNP) was considered as a primary endpoint, and myocardial structure, function and damage were secondary endpoints.

The three disease cohort groups had greater cardiac remodelling, worsening of function and elevated NT-proBNP/high-sensitivity Troponin-T (hsTnT) than older age control groups. A higher level of NT-proBNP was seen in AS-ATTR group (2844 ng/dL) (1745, 4635 respectively)  compared with AS (1294 ng/dL) (1077, 1554 respectively), whereas it wasn’t significantly different from ATTR (3272 (2552, 4197) ng/dL) group. Between the AS-ATTR and ATTR groups, prevalence of carpal tunnel syndrome, hsTnT and diastology were statistically similar but higher than AS. Left ventricular mass noted in AS-ATTR group was lesser than ATTR (139 (112, 167) which was lesser than ATTR (139 (112, 167) while it was non-significantly yet different from AS (120 (109, 130) g; p=0.179).

Researchers concluded that an early degree of amyloid infiltration is probably seen by in the AS-ATTR phenotype. However, an aggregate of AS-ATTR resembles ATTR patients. ATTR-specific treatment even after TAVI is likely to be beneficial even after of AS is resolved.


Disease Condition,Therapeutic Modality ,Valvular heart disease,Interventional Cardiology,Aortic Stenosis,Trans catheter Therapy


Disease Condition ,Therapeutic Modality ,Valvular heart disease,Interventional Cardiology,Aortic Stenosis,Trans catheter Therapy