2023 update in the diagnosis & management of cardiac amyloidosis. Welcome our friend and colleague Dr. Justin Grodin @JLGrodin @UTSWNews to #HeartFailure Grand Rounds @HarringtonHVI @UHhospitals twitter.com/i/web/status/1…
Amyloidosis is a protein misfolding disorder. Dr. Grodin @JLGrodin #HeartFailure Grand Rounds @UHhospitals
Myocardium histology and pathology. Thick rubbery myocardium. @JLGrodin
Natural history of cardiac amyloidosis, but by the time most of us will meet them they have advanced symptomatic disease. @JLGrodin
There are many types of cardiac amyloid disease... but 95% of the time the patients we see will have AL or ATTR. @JLGrodin
AL amyloidosis. >3000 new cases/year in the US. AL is more aggressive than ATTR, and early diagnosis is important. @JLGrodin
Origin of the word transthyretin? "TRANSport THYroxine and RETINol" @JLGrodin #HeartFailure Grand Rounds @UHhospitals @HarringtonHVI
Approximately 1.5M African Americans carry the V122I gene. Very long latency phase, goals of research is to identify disease early. @JLGrodin
ATTRwt = "Senile Systemic Amyloidosis." Appears to be a disease of aging with >50% of individuals in their 90s having evidence of deposition. @JLGrodin
Biventricular thickening is *NOT* LVH, this is thickening from amyloid protein. @JLGrodin
Important pearl in cardiac amyloidosis: atria are universally involved and atrial function is poor. CHADS-VASC score doesn't apply, stroke risk is high, must consider anticoagulation. @JLGrodin
LVEF is misleading, a poor marker of cardiac function. @JLGrodin
Fascinating atypical presentation of cardiac amyloidosis: obliteration of coronary arteries by amyloid protein. @JLGrodin
Cardiac amyloidosis: echocardiography, ECG, and cMRI are useful but not amyloid-type specific. @JLGrodin
Amyloid type-specific testing: FLC, tech PYP scanning, and tissue biopsy. @JLGrodin
How do we achieve a "non-biopsy" diagnosis of cardiac amyloidosis? use tech PYP scan in combination with serum free light chain blood work. @JLGrodin
An important contemporary diagnostic algorithm for evaluation of cardiac amyloidosis. @JLGrodin @maz_hanna
Future of cardiac amyloidosis diagnostics: #evuzamitide. Heart Failure Grand Rounds @HarringtonHVI @UHhospitals Dr. Justin Grodin @JLGrodin
TTR silencers: two approaches in treatment of transthyretin cardiac amyloidosis. @JLGrodin
Only FDA approved for hereditary TTR polyneuropathy. Cost is extreme... @JLGrodin
Future silencer? NTLA-2001, a CRISPR-based gene editing therapy. @JLGrodin
A different approach to therapy of cardiac amyloidosis: tetramer stabilizers. @JLGrodin
Share this Scrolly Tale with your friends.
A Scrolly Tale is a new way to read Twitter threads with a more visually immersive experience.
Discover more beautiful Scrolly Tales like this.