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Cardiac Involvement in Senile Systemic Amyloidosis

Cardiac amyloidosis in older adults caused by myocardial deposition of wild-type transthyretin without mutation.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

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What is Cardiac Involvement in Senile Systemic Amyloidosis?

Senile systemic amyloidosis, or wild-type transthyretin amyloidosis (ATTRwt), is a form of systemic amyloidosis that develops in older adults (usually over 70) when wild-type (non-mutated) transthyretin produced by the liver dissociates and deposits in the myocardium.

Cardiac involvement manifests as restrictive cardiomyopathy, heart failure (particularly with preserved ejection fraction), conduction disturbances and atrial fibrillation. Patients may also show musculoskeletal findings such as lumbar spinal stenosis, bilateral carpal tunnel syndrome and biceps tendon rupture.

Diagnosis can be made with 99mTc-PYP/DPD/HMDP scintigraphy; serum/urine immunofixation and free light chains should be checked to exclude AL amyloidosis. The TTR stabilizer tafamidis reduces heart failure events and mortality; RNAi-based agents such as patisiran and vutrisiran are also available.

Symptoms

Progressive dyspnea
Leg edema
Orthopnea
Fatigue
Palpitations from atrial fibrillation
Bilateral carpal tunnel symptoms
Orthostatic hypotension

Risk Factors

Advanced age (70+)
Male sex
Unexplained left ventricular hypertrophy
Lumbar spinal stenosis
Bilateral carpal tunnel syndrome
Biceps tendon rupture
Unexplained heart failure

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Unexplained cardiac hypertrophy in an older patient
  • Heart failure with preserved ejection fraction
  • Bilateral carpal tunnel with heart failure
  • Lumbar spinal stenosis with cardiac symptoms
  • Refractory atrial fibrillation
  • Discordance between low-voltage ECG and hypertrophy

Treatment Methods

01
Tafamidis (TTR stabilizer)
02
Patisiran or vutrisiran (RNAi-based)
03
Heart failure therapy (diuretics, MRA)
04
Anticoagulation for atrial fibrillation
05
Pacemaker in conduction disease
06
Low-dose beta-blocker with caution
07
Multidisciplinary amyloidosis clinic follow-up

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.