AI Article Synopsis
- - Cardiac amyloidosis is becoming recognized as a treatable type of heart failure, with effective therapies now available for its two common forms: immunoglobulin light chain amyloidosis and transthyretin (ATTR) amyloidosis.
- - Accurate treatment initiation depends on the proper identification of cardiac amyloidosis and the specific amyloid type, with noninvasive methods available for ATTR but histological confirmation still needed for many cases.
- - The review outlines the need for histological typing in certain patients and discusses various techniques for amyloid deposit typing, including mass spectrometry, immunohistochemistry, and immunoelectron microscopy, along with their pros and cons in clinical usage.
Article Abstract
Cardiac amyloidosis is increasingly recognized as a treatable form of heart failure. Highly effective specific therapies have recently become available for the 2 most frequent forms of cardiac amyloidosis: immunoglobulin light chain amyloidosis and transthyretin (ATTR) amyloidosis. Nevertheless, initiation of specific therapies requires recognition of cardiac amyloidosis and appropriate characterization of the amyloid type. Although noninvasive diagnosis is possible for ATTR cardiac amyloidosis, histological demonstration and typing of amyloid deposits is still required for a substantial number of patients with ATTR and in all patients with light chain amyloidosis and other rarer forms of cardiac amyloidosis. Amyloid histological typing can be performed using different techniques: mass spectrometry, immunohistochemistry, and immunoelectron microscopy. This review describes which patients require histological confirmation of cardiac amyloidosis along with when and how to type amyloid deposits in histologic specimens. Furthermore, it covers the characteristics and limitations of the different typing methods that are available in clinical practice.
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| http://dx.doi.org/10.1016/j.jacc.2024.01.010 | DOI Listing |
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