4.7 Article

Pathophysiology and Therapeutic Approaches to Cardiac Amyloidosis

期刊

CIRCULATION RESEARCH
卷 128, 期 10, 页码 1554-1575

出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/CIRCRESAHA.121.318187

关键词

amyloidosis; biopsy; cardiomyopathy; incidence; light chain; prevalence; rare disease; transthyretin

资金

  1. National Institutes of Health [HL139671-01, AG R21AG058348, AG K24AG036778]

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Cardiac amyloidosis, once considered a rare disease, is now increasingly recognized due to aging population and noninvasive diagnostic methods. Better understanding of the pathogenesis of cardiac amyloidosis has led to the development of multiple effective therapies.
Often considered a rare disease, cardiac amyloidosis is increasingly recognized by practicing clinicians. The increased rate of diagnosis is in part due the aging of the population and increasing incidence and prevalence of cardiac amyloidosis with advancing age, as well as the advent of noninvasive methods using nuclear scintigraphy to diagnose transthyretin cardiac amyloidosis due to either variant or wild type transthyretin without a biopsy. Perhaps the most important driver of the increased awareness is the elucidation of the biologic mechanisms underlying the pathogenesis of cardiac amyloidosis which have led to the development of several effective therapies with differing mechanisms of actions. In this review, the mechanisms underlying the pathogenesis of cardiac amyloidosis due to light chain (AL) or transthyretin (ATTR) amyloidosis are delineated as well as the rapidly evolving therapeutic landscape that has emerged from a better pathophysiologic understanding of disease development.

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