Cardiac amyloidosis – an underdiagnosed cause of heart failure with preserved ejection fraction – updated diagnosis and treatment options

Abstract

Cardiac amyloidosis (CA) still represents a frequently missed cause of heart failure with preserved ejection fraction (HFpEF). In the light of many new and effective therapies for immunoglobulin light chain amyloidosis (AL) and for transthyretin amyloidosis (ATTR), screening for amyloidosis as an important and potentially treatable diagnosis under the HFpEF becomes mandatory. A step-by-step algorithm for CA in HF patients was already provided by the guidelines. This review summarizes the role of all imaging modalities and biomarkers in the diagnosis and prognosis of both subtypes, the algorithm for diagnosis of CA, and new therapeutic options. It is the fi rst Romanian publication which intends to bring altogether the current recommendations in the diagnosis and management of CA.