系统性心脏淀粉样变性的嗅觉和味觉损害：一项前瞻性病例对照研究

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology Pub Date : 2025-04-30 DOI:10.1016/j.amjoto.2025.104665

Clémentine Hyvrard , Maxime Fieux , Thibaud Damy , Marina Dockes , Marion Renaud , Julien Lucas , Axelle Coban , Margaux Petitjean , Nisrine Khemies , Florence Canouï-Poitrine , Imene Nouri , Mounira Kharoubi , André Coste , Emilie Bequignon , Sophie Bartier

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引用次数: 0

摘要

目的淀粉样变性是一种多系统疾病，预后较差。我们假设淀粉样蛋白可以沿着嗅觉和味觉系统沉积，导致嗅觉和味觉损伤。目的是评估被诊断为心脏淀粉样变性（CA）的患者群体中嗅觉和味觉障碍的患病率。方法前瞻性纳入3种淀粉样蛋白亚型（遗传性或野生型甲状腺转甲状腺素（ATTRv和ATTRwt）和轻链（AL））患者和对照组慢性非淀粉样心力衰竭患者。进行鼻内窥镜检查、嗅觉和味觉问卷调查、“短嗅棒”测试（sSST）和味觉条测试。结果38例CA患者，平均年龄80.8±8.6岁；65.8%男性)和13例对照患者(平均年龄63.2±16.4岁；53.8%为男性)。CA患者的sSST平均总分显著低于对照组（15.4±6.2 vs 20.3 +/−5.3,p = 0.02）。38例CA患者中有5例（13.1%）主诉嗅觉障碍，而对照组为3/13例（23.1%）。味觉损伤发生率为24/37(64.9%)，对照组为6/12 (50%)(p >；0.05)。结论本研究比较了CA患者与慢性非淀粉样变性心力衰竭患者的嗅觉功能，发现CA患者有明显更多的嗅觉障碍。因此，嗅觉障碍可能是一个新的“危险信号”，可能有助于CA的早期诊断和治疗。

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Olfactory and gustatory impairment in systemic cardiac amyloidosis: a prospective case-control study

Purpose

Amyloidosis is a multi-systemic disease with a poor prognosis. We hypothesized that amyloid proteins could deposit along the olfactory and gustatory systems and cause olfactory and gustatory impairment. The objective was to assess the prevalence of olfactory and gustatory disorders in a population of patients diagnosed with cardiac amyloidosis (CA).

Methods

CA patients from three amyloid subtypes (hereditary or wild-type transthyretin (ATTRv and ATTRwt) and light chain (AL)) and a control group of patients with chronic non-amyloidotic heart failure were enrolled prospectively in this case-control study. Nasal endoscopy, olfactory and gustatory questionnaires, “shortened Sniffin’ Sticks” test (sSST) and Taste Band Strips test were performed.

Results

Thirty-eight CA patients (mean age of 80.8 +/− 8.6 years; 65.8 % males) and 13 control patients (mean age of 63.2 +/− 16.4 years; 53.8 % males) were included. The mean total score on the sSST for CA patients was significantly lower than that of the control group (15.4±6.2 vs 20.3 +/− 5.3, respectively, p = 0.02). Five out of 38 (13.1 %) CA patients were complaining of dysosmia compared to 3/13 (23.1 %) patients in the control group. Taste impairment was noted in 24/37 (64.9 %) CA patients vs 6/12 (50 %) patients in the control group (p > 0.05).

Conclusion

This study comparing olfactory function of CA patients to chronic non-amyloidotic heart failure patients found that CA patients had significantly more olfactory impairments. Olfactory impairments could therefore be a new “red flag” that may help in early diagnosis and treatment of CA.

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来源期刊

American Journal of Otolaryngology 医学-耳鼻喉科学

CiteScore

4.40

自引率

4.00%

发文量

378

审稿时长

41 days

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