Aortic Stenosis and Cardiac Amyloidosis,Journal of the American College of Cardiology

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Aortic Stenosis and Cardiac Amyloidosis
Journal of the American College of Cardiology ( IF 21.7 ) Pub Date : 2019-11-01 , DOI: 10.1016/j.jacc.2019.09.056
Julien Ternacle ₁ , Laura Krapf ₂ , Dania Mohty ₃ , Julien Magne ₄ , Annabelle Nguyen ₅ , Arnault Galat ₅ , Romain Gallet ₅ , Emmanuel Teiger ₅ , Nancy Côté ₆ , Marie-Annick Clavel ₆ , François Tournoux ₇ , Philippe Pibarot ₆ , Thibaud Damy ₅

Affiliation

Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Université Laval, Québec City, Québec, Canada; Referral Center for Cardiac Amyloidosis, Mondor Amyloidosis Network, GRC Amyloid Research Institute and Cardiology Department, APHP Henri Mondor Hospital, Créteil, France; INSERM Unit U955, Team 8, Paris-Est Creteil University, Val-de-Marne, Créteil, France.
Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Université Laval, Québec City, Québec, Canada; Cardiology Department, Centre d'Accueil et de Soins Hospitaliers, Hôpital Max Fourestier, Nanterre, France.
CHU Limoges, Hôpital Dupuytren, Service Cardiologie, and INSERM 1094, Faculté de médecine de Limoges, Limoges, France; King Faisal Specialist Hospital & Research Center, Heart Center, Riyadh, Saudi Arabia.
CHU Limoges, Hôpital Dupuytren, Service Cardiologie, and INSERM 1094, Faculté de médecine de Limoges, Limoges, France.
Referral Center for Cardiac Amyloidosis, Mondor Amyloidosis Network, GRC Amyloid Research Institute and Cardiology Department, APHP Henri Mondor Hospital, Créteil, France; INSERM Unit U955, Team 8, Paris-Est Creteil University, Val-de-Marne, Créteil, France.
Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Université Laval, Québec City, Québec, Canada.
Cardiology Department, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.

The prevalence of calcific aortic stenosis (AS) and of cardiac amyloidosis (CA) increases with age, and their association is not uncommon in the elderly. The identification of CA is particularly challenging in patients with AS because these 2 conditions share several features. It is estimated that ≤15% of the AS population and ≤30% of the subset with low-flow, low-gradient pattern may have CA. In patients with AS, CA is associated with increased risk of heart failure, mortality, and treatment futility with aortic valve replacement. In case of suspicion of CA, it is thus crucial to confirm the diagnosis to guide therapeutic management of AS and eventually implement recently developed pharmacological treatment dedicated to transthyretin amyloidosis. Given the high surgical risk of patients with AS and concomitant CA, transcatheter aortic valve replacement may be preferred to surgery in these patients.

中文翻译：

主动脉瓣狭窄和心脏淀粉样变性

钙化性主动脉瓣狭窄 (AS) 和心脏淀粉样变性 (CA) 的患病率随着年龄的增长而增加，并且它们的关联在老年人中并不少见。在 AS 患者中识别 CA 尤其具有挑战性，因为这两种情况有几个共同特征。估计≤15%的AS人群和≤30%的低流量、低梯度模式的子集可能有CA。在 AS 患者中，CA 与主动脉瓣置换术后心力衰竭、死亡率和治疗无效的风险增加有关。因此，在怀疑 CA 的情况下，确认诊断以指导 AS 的治疗管理并最终实施最近开发的专门用于转甲状腺素蛋白淀粉样变性的药物治疗至关重要。鉴于 AS 和 CA 患者的高手术风险，

更新日期：2019-11-01

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