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Amyloid cardiomyopathy (CA) was previously considered a rare disease; however, rapid advancements in imaging modalities have led to an increased frequency of its diagnosis. The aim of this prospective study was to assess the prevalence and clinical phenotype of transthyretin amyloidosis (ATTR) cardiomyopathy in patients exhibiting unexplained increased left ventricular (LV) wall thickness. From 2020 to 2022, we enrolled 100 consecutive adults with unexplained increased LV wall thickness in the study. The analysis included clinical data, electrocardiography, transthoracic echocardiography, single-photon emission computed tomography/computed tomography with 3,3-disphono-1,2-propanodicarboxylic acid, genetic testing. Overall, 18% of patients were diagnosed with CA, comprising 5% with light-chain amyloidosis, and 12% with ATTR. To evaluate associations with the ATTR diagnosis, a LOGIT model and multivariate analysis were applied. Notably, age, polyneuropathy, gastropathy, carpal tunnel syndrome, lumbar spine stenosis, low voltage, ventricular arrhythmia, LV mass, LV ejection fraction, global longitudinal strain (GLS), E/A, E/E', right ventricle (RV) thickness, right atrium area, RV VTI, TAPSE, apical sparing, ground glass appearance of myocardium, thickening of interatrial septum, thickening of valves, and the "5-5-5" sign were found to be significantly associated with ATTR (p < 0.05). The best predictive model for ATTR diagnoses exhibited an area under the curve of 0.99, including LV mass, GLS and RV thickness. This study, conducted at a cardiology referral center, revealed that a very considerable proportion of patients with unexplained increased LV wall thickness may suffer from underlying CA. Moreover, the presence of ATTR should be considered in patients with increased LV mass accompanied by reduced GLS and RV thickening.
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http://dx.doi.org/10.1007/s10554-024-03158-z | DOI Listing |
Am J Trop Med Hyg
December 2024
University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali.
Unexplained fever poses significant diagnostic challenges in resource-limited settings like Bamako, Mali, where overlapping endemic diseases include malaria, HIV/AIDS, yellow fever, typhoid, and others. This study aimed to elucidate the infectious etiologies of acute febrile illnesses in this context. Acute febrile patients of any age were enrolled after informed consent or assent.
View Article and Find Full Text PDFActa Paediatr
December 2024
Department of Paediatrics, Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Aim: To evaluate whether extremely preterm infants with considerable gastrointestinal (GI) symptoms during the neonatal period, but without major abdominal surgery or necrotising enterocolitis, had an increased probability of developing GI dysfunction later in life.
Methods: A retrospective, case-control study on extremely preterm neonates that underwent an upper gastrointestinal contrast series (UGI) between 2012 and 2017, with UGI used as a marker of considerable GI symptoms. Controls were matched for sex and gestational age.
Eur J Prev Cardiol
December 2024
Cardiovascular and Genomics Institute, City St George's University of London, Cranmer Terrace, London SW17 0RE, UK.
Aims: Sudden arrhythmic death syndrome (SADS) refers to a sudden death, which remains unexplained despite comprehensive post-mortem examination and a toxicological screen. We aimed to investigate the impact of age and sex on the overall diagnostic yield and underlying aetiology in decedents with SADS using a combined approach of familial evaluation (FE) and molecular autopsy (MA).
Methods And Results: Consecutive referrals to a single centre for FE only, MA only or both, following a SADS death were included.
BMC Pregnancy Childbirth
December 2024
Department of Obstetrics and Gynecology, The First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou, Fujian, 350005, P.R. China.
Background: Recurrent spontaneous abortion (RSA), whose underlying cause has yet to be fully elucidated, is often classified as unexplained recurrent spontaneous abortion (URSA). Promoting the differentiation of CD4 T cells into Tregs may be the key to prevent URSA. The differentiation of CD4 T cells was controlled by mTOR, but the regulatory mechanism is still unclear.
View Article and Find Full Text PDFFree Radic Biol Med
December 2024
Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, 466-8560, Japan; Department of Ophthalmology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3125, Japan. Electronic address:
Vitrectomy with silicone oil (SO) endotamponade is an effective treatment for vision-threatening retinal diseases. However, unexplained vision impairment has been reportedly critical side effects. Previously, we reported that the eyes with ocular toxoplasmosis showed retinal ferroptosis with the clinical sign of reduced intravitreal iron (Fe).
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