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0353: Prevalence of hereditary transthyretin cardiac amyloidosis in patients with increase in LV thickness in France

Abstract : Background Hereditary transthyretin cardiac amyloidosis (mTTR-CA) is a hypertrophic cardiomyopathy with challenging diagnosis and poor prognosis. The prevalence of m-TTR in patients with increased left ventricular wall thickness (LVWT) is unknown. Methods Prospective and consecutive multicenter study with systematic genetic screening for mTTR in adult patients with LVWT ≥15mm included in cardiology primary clinics. Results 298 patients were genotyped of whom 23% were African descendant. The median (IQR) age was 62(50,74), 74% were men and 36% were in NYHA class III-IV. The median of maximal LV thickness was 18 (16, 21)mm.17 patients had TTR mutation (5.7%) of whom 15 (5.0) had confirmed mTTR-CA. All the mTTR-CA were ≥55years meaning that the prevalence of mTTR-CA was 8.3% above this age. Of the 15 with mTTR-CA, 8 were Africans and 6 Caucasians. In Africans ≥55 years, the prevalence was 22% and reached 35% in those over 65 years. The most frequent mutations were V142I (8), V50M (2) and I127V (2). When adjusted to age, neuropathy (OR=20.1; 95%-CI, 5.86-69.4; P<0.001), carpal tunnel syndrome (OR=15.31; 95%-CI, 4.32-54.3; P<0.001), ECG low voltage (OR=8.8; 95%-CI, 2.67-29.1; P<0.001), symmetric hyper-trophy (OR=10.9; 95%-CI, 1.97-59.8; P=0.006), LVEF impairment (OR=10.9; 95%-CI, 1.62-15.5; P=0.005), and late gadolinium enhancement at MRI (OR=42.9; 95%-CI, 2.38-772; P=0.011) were all associated with increased odds of CA. Conclusions mTTR-CA is frequent in HCM, particularly in African descendant and patients ≥55 years. mTTR genetic screening may be warranted for patients with increased LVWT, especially with neuropathy or carpal tunnel syndrome or LGE at MRI
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-01302073
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Submitted on : Wednesday, April 13, 2016 - 3:17:52 PM
Last modification on : Sunday, October 25, 2020 - 7:06:22 AM

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Thibaud Damy, Bruno Costes, Alain Hagège, Erwan Donal, Jean-Christophe Eicher, et al.. 0353: Prevalence of hereditary transthyretin cardiac amyloidosis in patients with increase in LV thickness in France. Archives of Cardiovascular Diseases Supplements, Elsevier/French Society of Cardiology, 2016, 26es Journées européennes de la Société Française de cardiologie, 8 (1), pp.25. ⟨10.1016/S1878-6480(16)30074-X⟩. ⟨hal-01302073⟩

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