P207 DIAGNOSTIC PATHWAY OF CARDIAC AMYLOIDOSIS. INSIGHTS FROM CUNEO HOSPITAL

Abstract Introduction In the last fifteen years, thanks to refinement of non–invasive diagnostic techniques, there has been a clear increase in diagnosis amyloidosis. From this need arises establishment specific out–patients department order guarantee best path and treatment. Methods Since 2018 we have begun suspect cardiac amyloidosis hospitalized patients with heart failure preserved ejection fraction clinical and/or instrumental red flags: left ventricular hypertrophy unexplained by other causes, biatrial enlargement, minimal pericardial effusion, history carpal tunnel, low voltages peripheral leads, elevated values ​​of biomarkers. these excluded AL searching for monoclonal components at same time performed myocardial scintigraphy diphosphonates. case positive scintigraphy, are taken care our cardiology rare disease outpatient clinic. We believe that collaboration is essential correct management patient amyloidosis, especially an area like ours where high prevalence mutation, val30met, prevailing initial neurological involvement. Results 2019, 156 underwent bone The average age 78 years. 87 scintigraphies were (Perugini 2–3), 47 diagnosed TTRwt 3 TTRv 38 awaiting genetic testing. 34% organ biopsy (of which 10 salivary gland biopsy, periumbilical fat 1 BEM another center. 25% MRI. 7 started Tafamidis. Conclusions Amyloidosis frequently underdiagnosed disease. An early crucial undertake, cases allow it, therapy: chemotherapy or disease–modifying drugs TTR. experience center shown us how multidisciplinary approach achieve establish therapeutic paths can modify natural