Clinical experience of a systemic algorithm for diagnosis of cardiac amyloidosis.

IF 1.2 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Danish medical journal Pub Date : 2025-08-07 DOI:10.61409/A11240771

Julie Bjerre Tarp, Marie Bayer Elming, Lisbeth Marner, Christian Haarmark, Alex Hørby Christensen, Jens Jakob Thune

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引用次数: 0

Abstract

Introduction: Cardiac amyloidosis is an underdiagnosed disease, and its prevalence is probably higher than previously estimated. We aimed to investigate the effect of introducing a systemic diagnostic algorithm for cardiac amyloidosis in clinical practice.

Methods: A systematic diagnostic algorithm was developed and clinically applied in two hospitals in Eastern Denmark. Elderly patients (males > 60 years, females > 70 years) with left ventricular hypertrophy (≥ 12 mm) and diastolic dysfunction leading to a suspicion of cardiac amyloidosis were referred for standardised workup, including biochemistry and bone scintigraphy.

Results: A total of 224 patients (median age 76 years (70-83); 65% males) were included in the analysis. In total, 43 (19%) patients (84% males) were diagnosed with cardiac amyloidosis. Among the 43 diagnosed patients, 38 had transthyretin wild-type amyloidosis, one had the hereditary form and four had monoclonal-immunoglobulin-light-chain amyloidosis. Patients with cardiac amyloidosis were significantly older (81 versus 75 years old, p less-than 0.001) and more often male (84% versus 61%, p = 0.004) than the overall screened population.

Conclusions: Systematic screening for cardiac amyloidosis in older patients with cardiac hypertrophy and echocardiographic signs of diastolic dysfunction is feasible and shows a diagnostic yield of 19% in the assessed population.

Funding: None.

Trial registration: Not relevant.

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一种系统算法诊断心脏淀粉样变的临床经验。

心脏淀粉样变性是一种未被诊断的疾病，其患病率可能高于先前的估计。我们的目的是研究在临床实践中引入心脏淀粉样变性的系统诊断算法的效果。方法：采用系统的诊断算法，在丹麦东部两家医院进行临床应用。老年患者（男性bbb60岁，女性bbb70岁）左心室肥厚（≥12 mm）和舒张功能障碍导致怀疑心脏淀粉样变性，纳入标准化检查，包括生物化学和骨显像。结果：共224例患者，中位年龄76岁（70-83岁）；65%的男性)被纳入分析。总共有43例（19%）患者（84%为男性）被诊断为心脏淀粉样变性。43例确诊患者中，38例为转甲状腺素野生型淀粉样变，1例为遗传性淀粉样变，4例为单克隆免疫球蛋白轻链淀粉样变。与总体筛查人群相比，患有心脏淀粉样变性的患者明显更老（81岁vs 75岁，p < 0.001），而且男性更常见（84% vs 61%, p = 0.004）。结论：对伴有心脏肥厚和舒张功能不全超声心动图征象的老年患者进行系统的心脏淀粉样变性筛查是可行的，在评估人群中诊断率为19%。资金:没有。试验注册：不相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Danish medical journal MEDICINE, GENERAL & INTERNAL-

CiteScore

2.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： The Danish Medical Journal (DMJ) is a general medical journal. The journal publish original research in English – conducted in or in relation to the Danish health-care system. When writing for the Danish Medical Journal please remember target audience which is the general reader. This means that the research area should be relevant to many readers and the paper should be presented in a way that most readers will understand the content. DMJ will publish the following articles: • Original articles • Protocol articles from large randomized clinical trials • Systematic reviews and meta-analyses • PhD theses from Danish faculties of health sciences • DMSc theses from Danish faculties of health sciences.