Does my TAVR patient have cardiac amyloidosis?

Abstract Introduction Aortic stenosis (AS) is highly age-related, and its prevalence increasing rapidly in high-income countries. There are 2 major types of amyloid protein responsible for cardiac amyloidosis (CA) - transthyretin (TTR) immunoglobulin lightchain (AL). Previous cohorts report an incidence ranging from 9 to 16% the presence CA patients with AS referred TAVR. These appear have a similar prognosis those lone when undergoing TAVR, but trend toward worse if left treated. We aimed investigate severe TAVR Portuguese population. Methods prospectively recruited 60 consecutive at our tertiary center between November 2020 May 2021. 59 agreed participate signed informed consent, approved by local Ethics Commission. All performed coronary angiogram, echocardiogram, thoracic abdominal pelvic CT scan, ECG, bone scintigraphy (99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid [DPD]) blood urine monoclonal testing. (Figure 1). Results About half (54.2%) were male, average age was 82 years ischemic heart disease cardiovascular risk factors high. one third had atrial fibrillation 27.1% pacemaker carriers. Echocardiographic baseline findings were: maximum aortic valve gradient 72.77±18.18 mmHg; mean 43.49±11.60; area 0.65±0.15 cm2; interventricular septum thickness 1.30±0.23 cm; ventricular ejection fraction (LVEF) 52.06±11.35%; E/E' 14.63±7.5; tricuspid annular plane systolic excursion 19.2±4mm; right ventricle/ 38.1±14.32mmHg. diagnosed 6 (10.2%) patients. Perugini grade 1 (n=3) 3 (n=3). One patient (Perugini = 3) found plasma cell dyscrasia, producing IgG Kappa protein. all older (86.5 vs 81.30 years, p=0.049), more frequently carriers (66.7 22.6%, p=0.041) tendency thicker (1.48 1.28 cm, p=0.065). Conclusions show that population, TAVI line what observed other This has important consequences regarding diagnosis management these Funding Acknowledgement Type funding sources: None.