Context
Aortic stenosis (AS) and transthyretin amyloidosis (ATTR) are diseases with increased prevalence at higher age. We report our single centre experience on ATTR detection among patients with AS to provide insight on the prevalence and clinical features of dual pathology as compared to lone AS.
Purpose
We aim to identify the concomitant prevalence of ATTR in patients with severe AS undergoing transcatheter aortic valve replacement (TAVR) and propose echocardiographic parameters and morphological signs suggestive of ATTR in these patients.
Methods
In a prospective observational study, we are including patients with severe AS undergoing TAVR. Each patient undergoes comprehensive transthoracic echocardiographic examination prior and after TAVR. Non-invasive screening for ATTR was performed using 99mTc-DPD bone scintigraphy. We report preliminary results from our study.
Results
We present the results of 106 patients included in the study between January 2022 and October 2024. 99mTc-DPD bone scintigraphy lead to diagnosis of ATTR in 11 subjects (10,3 %).
Compared to patients with AS alone, those with coexisting ATTR exhibited a lower pressure gradient on the aortic valve (p<0.05) and a reduced velocity time integral of the aortic valve (p<0.001) suggesting low-flow state. Additionally, we observed higher systolic pulmonary artery pressure (p<0.05) in ATTR positive subjects. These patients also presented with a lower global longitudinal strain, significantly thicker interventricular septum and an increased left ventricular mass.
Conclusions
Among severe AS patients, ATTR is prevalent and presents with phenotypic features that may aid to differentiate it from lone AS. We continue recruiting patients to propose echocardiographic markers suggestive of ATTR to enable early diagnostics and subsequent treatment.
