Transthyretin amyloid cardiomyopathy in severe aortic stenosis submitted to valve replacement: a multicenter study

Aim: To evaluate the prevalence of TTR amyloid cardiomyopathy (ATTR-CM) in severe aortic stenosis (SAS) patients, and to determine the independent predictors of major adverse events (MAE). Patients & methods: 91 SAS patients >65 years with an interventricular septum thickness >= 12.5 mm were referred for aortic valve replacement (AVR). 99mTc-DPD scintigraphy was applied to diagnose ATTR-CM, in the absence of monoclonal protein. Results: ATTR-CM was found in 11%. 78% of patients underwent AVR, but only 2 had ATTR-CM. There were no significant differences in the composite of all cause-mortality or cardiovascular hospitalizations. Lower left ventricle ejection fraction and not performing AVR were independent predictors of MAE. Conclusion: Not performing AVR was an independent predictor of MAE, regardless the ATTR-CM diagnosis.