[Management of cardiac amyloidosis in Italy: a national survey of the Italian Cardiac Amyloidosis Network (RIAC)].

Background: The national survey of the SIC-ANMCO Amyloidosis Centers was designed to create a geographical mapping of the centers that identify and follow patients with cardiac amyloidosis in Italy and to describe their diagnostic capabilities and multidisciplinary organization.

Methods: The survey was administered to 212 centers in Italy. Among them, 153 centers responded (72%), 31/35 (89%) of which were academic medical centers and 122/177 (69%) hospitals.

Results: The results revealed a prevalence of centers in the North and Center of Italy compared to the South and the Islands, highlighting a greater number of patients in heart failure/cardiomyopathy clinics in hospitals (53%) and in clinics dedicated to amyloidosis in academic medical centers (71%). Most centers have an internal multidisciplinary collaboration network with the neurologist (82% in total, 97% in academic medical centers and 78% in hospitals) and the hematologist (69% in total, in 94% and 63%, respectively) and have the possibility of performing on-site cardiac magnetic resonance imaging (74%, in 94% and 68%, respectively) and scintigraphy with bone tracers (52%, in 91% and 44%, respectively), or alternatively to refer patients to other centers thanks to well-structured or occasional collaborations. Conversely, only a minority of centers perform endomyocardial biopsy (31%, in 71% of academic medical centers and in 20% of hospitals) and a smaller number of academic medical centers perform sophisticated amyloid tissue typing techniques such as immunogold labeling (11%) and mass spectrometry (4%).

Conclusions: The survey provided important information on the current Italian situation, underlining the importance of collaboration between the various levels of the network, to guarantee the best possible pathways and treatments for all patients with amyloidosis.