دورية أكاديمية
Screening for Cardiac Amyloidosis 5 to 15 Years After Surgery for Bilateral Carpal Tunnel Syndrome.
| العنوان: | Screening for Cardiac Amyloidosis 5 to 15 Years After Surgery for Bilateral Carpal Tunnel Syndrome. |
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| المؤلفون: | Westin O; The Heart Center, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark. Electronic address: oscar.mikael.westin@regionh.dk., Fosbøl EL; The Heart Center, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark., Maurer MS; Columbia University Irving Medical Center, New York, New York, USA., Leicht BP; Gildhøj Private Hospital, Copenhagen, Denmark., Hasbak P; Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark., Mylin AK; Department of Hematology, Rigshospitalet, Copenhagen, Denmark., Rørvig S; Department of Pathology, Rigshospitalet, Copenhagen, Denmark., Lindkær TH; Department of Pathology, Rigshospitalet, Copenhagen, Denmark., Johannesen HH; Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark., Gustafsson F; The Heart Center, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark. |
| المصدر: | Journal of the American College of Cardiology [J Am Coll Cardiol] 2022 Sep 06; Vol. 80 (10), pp. 967-977. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Biomedical Country of Publication: United States NLM ID: 8301365 Publication Model: Print Cited Medium: Internet ISSN: 1558-3597 (Electronic) Linking ISSN: 07351097 NLM ISO Abbreviation: J Am Coll Cardiol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [New York, N.Y.] : Elsevier Biomedical, [c1983- |
| مواضيع طبية MeSH: | Amyloidosis*/complications , Amyloidosis*/diagnosis , Carpal Tunnel Syndrome*/complications , Carpal Tunnel Syndrome*/surgery , Heart Diseases*/diagnosis , Heart Diseases*/diagnostic imaging, Aged ; Amyloid/metabolism ; Amyloid Neuropathies, Familial/diagnosis ; Amyloid Neuropathies, Familial/epidemiology ; Amyloid Neuropathies, Familial/surgery ; Female ; Humans ; Male ; Prealbumin/metabolism |
| مستخلص: | Background: Bilateral carpal tunnel syndrome (CTS) is a common extracardiac manifestation of amyloidosis and usually predates overt cardiac amyloidosis (CA) by several years. Screening studies on patients undergoing CTS surgery have shown a low yield of CA (2.0%), but high prevalence of amyloid in the carpal ligament. The proportion of patients with amyloid in the carpal ligament who later develop CA is unknown. Objectives: The authors sought to investigate the prevalence of undiagnosed CA 5 to 15 years after surgery for bilateral CTS. Methods: Using national registries, the authors identified subjects aged 60 to 85 years with prior CTS surgery, where the first procedure on the second wrist was performed 5 to 15 years earlier. Invitations to participate in the study were sent by mail. Per international recommendations, the initial cardiac evaluation included echocardiography, 99m technetium-pyrophosphate scintigraphy, and assessment of monoclonal proteins in serum and urine. Results: A total of 250 subjects (35.7% of those invited) participated in the study. The median age was 70.4 years, and 50% were female. CA was diagnosed in 12 patients (4.8%; 95% CI: 2.5%-8.2%), and all cases were wild-type transthyretin amyloidosis (ATTRwt). The prevalence of ATTRwt in men was 8.8% (95% CI: 4.5%-15.2%; n = 11), and 21.2% (95% CI: 11.1%-34.7%) in male subjects ≥70 years with a BMI <30 kg/m 2 . All but 2 patients diagnosed with ATTRwt were in the lowest disease severity score (Mayo score). Conclusions: Screening for CA in patients with prior surgery for bilateral CTS finds approximately 5% with early-stage transthyretin CA. The clinical yield was higher (>1 in 5) when focusing on nonobese men ≥70 years, showing potential for systematic screening. Competing Interests: Funding Support and Author Disclosures The study was funded by independent research grants from Erik og Susanna Olesens Almenvelgørende Fond, Pfizer, Arvid Nilssons Fond, Højmosegård-legatet, Frimodt-Heineke Fonden, and Hjertecentrets forskningsudvalg, Rigshospitalet (Dr Westin). Dr Fosbøl has received an independent research grant from Novo Nordisk Foundation, outside the submitted work. Dr Maurer has received grant support from NIH grants R01HL139671, R21AG058348, and K24AG036778; has been a consultant for Intellia, Novo-Nordisk, Pfizer, Eidos, Prothena, Akcea, and Alnylam; and his institution has received clinical trial funding from Pfizer, Prothena, Eidos, and Alnylam. Dr Gustafsson has received personal fees from Abbott, AstraZeneca, Pfizer, Boehringer Ingelheim, Novartis, and Orion Pharma outside the submitted work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. (Copyright © 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.) |
| التعليقات: | Comment in: J Am Coll Cardiol. 2022 Sep 6;80(10):978-981. (PMID: 36049805) |
| فهرسة مساهمة: | Keywords: cardiac amyloidosis; carpal tunnel syndrome; early detection; screening |
| المشرفين على المادة: | 0 (Amyloid) 0 (Prealbumin) |
| تواريخ الأحداث: | Date Created: 20220901 Date Completed: 20220908 Latest Revision: 20221007 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.jacc.2022.06.026 |
| PMID: | 36049804 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1558-3597 |
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| DOI: | 10.1016/j.jacc.2022.06.026 |