1. Histological Typing in Patients With Cardiac Amyloidosis: JACC Review Topic of the Week.
- Author
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Gonzalez-Lopez E, McPhail ED, Salas-Anton C, Dominguez F, Gertz MA, Dispenzieri A, Dasari S, Milani P, Verga L, Grogan M, Palladini G, and Garcia-Pavia P
- Subjects
- Humans, Plaque, Amyloid, Amyloid, Immunohistochemistry, Amyloidogenic Proteins, Prealbumin, Amyloidosis pathology, Heart Failure diagnosis, Amyloid Neuropathies, Familial diagnosis, Cardiomyopathies diagnosis, Cardiomyopathies therapy
- 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., Competing Interests: Funding Support and Author Disclosures This study has been partially supported by Instituto de Salud Carlos III through the projects “PI18/0765 and PI20/01379” (cofunded by European Regional Development Fund/European Social Fund “A way to make Europe”/“Investing in your future”). The Centro Nacional de Investigaciones Cardiovasculares is supported by the Instituto de Salud Carlos III, the Ministerio de Ciencia e Innovación, the Pro-Centro Nacional de Investigaciones Cardiovasculares Foundation, and the Severo Ochoa grant (CEX2020-001041-S). This work was also supported by grants from the Italian Ministry of Health (Ricerca Finalizzata, grant #GR-2018-12368387), the Italian Ministry of Research and Education (PRIN 20207XLJB2), Cancer Research UK 4013 (C355/A26819), Fundación Científica Asociación Española Contra el Cáncer, and AIRC under the Accelerator Award Program. The authors have reported that they have no relationships relevant to the content of this paper to disclose., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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