Article Figures & Data
Figures
- Figure 1
Parasternal long-axis view on echocardiography demonstrates diffuse concentric left ventricular hypertrophy (arrows).
- Figure 2
Technetium-99m pyrophosphate scintigraphy. (A) Anterior and (B) left anterior oblique views in our patient demonstrated grade 2 to 3 myocardial uptake of the radiotracer (circles) 3 hours after injection, thus meeting diagnostic criteria for transthyretin amyloid cardiomyopathy.
Tables
Extracardiac manifestations Cardiac manifestations Imaging findings Bilateral carpal tunnel syndrome Persistent mildly elevated troponin levels Echocardiography: increased thickness of left ventricle, right ventricular free wall, atrioventricular valves, interatrial septum Unprovoked biceps tendon rupture Symptomatic hypotension or orthostasis in response to hypertensive medication Electrocardiography: discrepancy in QRS voltage and left ventricular thickness Lumbar stenosis Unexplained atrioventricular block, heart block, or bundle branch block Strain echocardiography: longitudinal impairment with apical sparing Sensorimotor polyneuropathy Elevated N-terminal-pro-brain natriuretic peptide not proportionate to severity of heart failure Cardiac magnetic resonance imaging: increased extracellular volume or late enhancement Autonomic dysfunction Family history of cardiomyopathy Chest radiography: cardiomegaly - TABLE 2
Disease-modifying therapies for transthyretin amyloidosis (ATTR) approved by the US Food and Drug Administration
Drug Indication Effect on transthyretin Tafamidis Wild-type or hereditary ATTR cardiomyopathy Stabilizer Vutrisiran Hereditary ATTR with neuropathy Silencer Patisiran Hereditary ATTR with neuropathy Silencer Inotersen Hereditary ATTR with neuropathy Silencer
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