Reverse cardiac remodelling and dysfunction in A97S transthyretin cardiac amyloidosis after tafamidis treatment

Transthyretin cardiomyopathy (ATTR-CM) is an under-recognized cause of heart failure, but it has received increasing attention due to the availability of treatment options. We present a case of hereditary transthyretin cardiomyopathy (A97S, an under-represented variant in current clinical studies) who presented with heart failure. Timely diagnosis and intervention with tafamidis demonstrated reversed cardiac remodelling via multiple imaging techniques (echocardiography, cardiac magnetic resonance imaging and technetium-99m pyrophosphate scintigraphy). The echocardiography and cardiac magnetic resonance imaging demonstrated improved global strain. Cardiac magnetic resonance imaging showed decreased extracellular volume. The technetium-99m pyrophosphate scintigraphy demonstrated decreased heart-to-contralateral ratio. This case highlights the potential reversible effect of tafamidis on A97S amyloidosis cardiomyopathy.

Automated summary

Transthyretin cardiomyopathy is a common but often overlooked cause of heart failure, but recent advances in treatment options have brought it into focus. In this case study, a patient with hereditary transthyretin cardiomyopathy presented with heart failure and was treated with tafamidis. The use of multiple imaging techniques demonstrated reversed cardiac remodeling, highlighting the potential reversible effect of tafamidis on this specific variant of amyloidosis cardiomyopathy.