Aortic Stenosis and Cardiac Amyloidosis

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:74

Review

Ternacle, Julien^1,2,3,4  Krapf, Laura^1,5  Mohty, Dania^6,7,8  Magne, Julien^6,7  Nguyen, Annabelle^2,3,4  Galat, Arnault^2,3,4  Gallet, Romain^2,3,4  Teiger, Emmanuel^2,3,4  Cote, Nancy¹  Clavel, Marie-Annick¹  Tournoux, Francois⁹  Pibarot, Philippe¹  Damy, Thibaud^2,3,4 

[1] Univ Laval, Quebec Heart & Lung Inst, Inst Univ Cardiol & Pneumol Quebec, Quebec City, PQ, Canada

[2] Henri Mondor Hosp, APHP, Mondor Amyloidosis Network, GRC Amyloid Res Inst,Referral Ctr Cardiac Amyloid, Creteil, France

[3] Henri Mondor Hosp, APHP, Dept Cardiol, Creteil, France

[4] Paris Est Creteil Univ, INSERM, Unit U955, Team 8, Creteil, France

[5] Hop Max Fourestier, Ctr Accueil & Soins Hosp, Cardiol Dept, Nanterre, France

[6] Hop Dupuytren, CHU Limoges, Serv Cardiol, Limoges, France

[7] Fac Med Limoges, INSERM 1094, Limoges, France

[8] King Faisal Specialist Hosp & Res Ctr, Ctr Heart, Riyadh, Saudi Arabia

[9] Ctr Hosp Univ Montreal, Cardiol Dept, Montreal, PQ, Canada

关键词: aortic stenosis;    cardiac amyloidosis;    Doppler echocardiography;    heart failure;    surgical aortic valve replacement;    tafamidis;    transcatheter aortic valve replacement;    transthyretin;   

DOI  :  10.1016/j.jacc.2019.09.056

来源: Elsevier

【 摘 要 】

The prevalence of calcific aortic stenosis (AS) and of cardiac amyloidosis (CA) increases with age, and their association is not uncommon in the elderly. The identification of CA is particularly challenging in patients with AS because these 2 conditions share several features. It is estimated that <= 15% of the AS population and <= 30% of the subset with low-flow, low-gradient pattern may have CA. In patients with AS, CA is associated with increased risk of heart failure, mortality, and treatment futility with aortic valve replacement. In case of suspicion of CA, it is thus crucial to confirm the diagnosis to guide therapeutic management of AS and eventually implement recently developed pharmacological treatment dedicated to transthyretin amyloidosis. Given the high surgical risk of patients with AS and concomitant CA, transcatheter aortic valve replacement may be preferred to surgery in these patients. (C) 2019 by the American College of Cardiology Foundation.

【 授权许可】

Free