Descriptive study of the clinical and myocardial status of a population with anatomopathological aortic valve amyloidosis

IF 2.3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Pathology Pub Date : 2024-07-16 DOI:10.1016/j.carpath.2024.107674

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引用次数: 0

Abstract

Background

Aortic stenosis (AS) and transthyretin (ATTR) cardiac amyloidosis (CA) share the same clinical profiles and cardiac phenotype. Amyloid deposits have been frequently reported in aortic valves of patients with severe AS referred for surgical aortic valve replacement (SAVR). The aim of this study was to determine the clinical and myocardial status of patients with aortic valve amyloidosis after aortic valve surgery.

Methods and results

We performed a retrospective descriptive study of 46 patients who underwent SAVR for severe AS with amyloid deposits upon histological analysis. All patients were screened for cardiac involvement. Amyloid deposits typing was successful in 35 (76%) patients and 28 (80%) were ATTR. Two (4%) had positive bone scintigraphy and among the 5 myocardial biopsies performed during surgery, 80% were positive for ATTR deposits.

Conclusion

ATTR is the predominant type in the presence of amyloid deposits on the aortic valve after surgery for severe AS but is only rarely accompanied by cardiac uptake on bone scintigraphy. Early stages of myocardial involvement are frequent and myocardial biopsy is more sensitive for detection of mild amyloid deposits than bone scintigraphy

Abstract Image

查看原文本刊更多论文

解剖病理学主动脉瓣淀粉样变性人群临床和心肌状况的描述性研究。

背景：主动脉瓣狭窄（AS）和转甲状腺素（ATTR）心脏淀粉样变性（CA）具有相同的临床特征和心脏表型。淀粉样蛋白沉积物经常出现在转诊为主动脉瓣置换术（SAVR）的重度主动脉瓣狭窄患者的主动脉瓣中。本研究旨在确定主动脉瓣手术后主动脉瓣淀粉样变性患者的临床和心肌状况：我们对46例因严重AS接受主动脉瓣置换术并经组织学分析有淀粉样沉积的患者进行了回顾性描述性研究。所有患者均接受了心脏受累筛查。35例（76%）患者的淀粉样沉积物分型成功，28例（80%）为ATTR。两名患者（4%）骨闪烁扫描呈阳性，在手术中进行的5例心肌活检中，80%的患者ATTR沉积呈阳性：结论：ATTR是严重AS手术后主动脉瓣上出现淀粉样沉积物的主要类型，但很少伴有骨闪烁扫描的心肌摄取。心肌受累的早期阶段很常见，心肌活检对检测轻度淀粉样沉积物比骨闪烁扫描更敏感。

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来源期刊

Cardiovascular Pathology 医学-病理学

CiteScore

7.50

自引率

2.70%

发文量

审稿时长

18 days

期刊介绍： Cardiovascular Pathology is a bimonthly journal that presents articles on topics covering the entire spectrum of cardiovascular disease. The Journal''s primary objective is to publish papers on disease-oriented morphology and pathogenesis from clinicians and scientists in the cardiovascular field. Subjects covered include cardiovascular biology, prosthetic devices, molecular biology and experimental models of cardiovascular disease.