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Learn about ATTR-CM and uncover the differences between hereditary and Wild-type ATTR-CM

Learn about the red flags that may raise suspicion of and techniques used to diagnose ATTR-CM

Explore a range of educational resources to support the diagnosis of ATTR-CM

Click here for Vyndaqel®▼ (tafamidis) Prescribing Information. Adverse event reporting information can be found at the bottom of the page.

Recognising signs and symptoms of ATTR-CM

The diagnosis of ATTR-CM is often delayed or missed, resulting in an underdiagnosed cause of heart failure with preserved ejection fraction (HFpEF). Wild-type ATTR-CM accounts for 13-17% of HFpEF cases.1,2

  • In an ex-US study of 120 HFpEF patients 60 years or older, wild-type ATTR was confirmed in 13% (13.3%; 95% CI: 7.2–19.5) of the patients1
  • In a US study of 441 autopsied patients, 109 of whom had HFpEF, cardiac wild-type ATTR deposits were found in 17% of the patients2

Patients with wild-type ATTR and hereditary ATTR present with heart failure, particularly HFpEF and other cardiac symptoms.3-5

Common signs and symptoms in wild-type ATTR and hereditary ATTR3,6-11

I Cardiac

  • Fatigue
  • Shortness of breath
  • Oedema
  • Arrhythmias
  • Heart failure with preserved ejection fraction (HFpEF)
  • Aortic stenosis
  • Orthostatic hypotension
  • Erectile dysfunction

| Soft tissue

  • Lumbar stenosis
  • Ruptured distal biceps tendon
  • Eye involvement – glaucoma, intravitreal deposition, scalloped pupils

I GI

  • Diarrhoea
  • Constipation
  • Nausea
  • Early satiety

| Neurologic

  • Bilateral carpal tunnel syndrome (CTS)
  • Sensory-motor polyneuropathy
  • Weakness

Building the knowledge: One disease with many faces

This is a series of animated, educational modules that outline key background information on ATTR amyloidosis. This video breaks down the various types of ATTR amyloidosis and the clinical clues that can raise suspicion of ATTR-CM.

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Consider the clinical clues and need for further testing

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See other educational resources available

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References:
  1. González-López E, Gallego-Delgado M, Guzzo-Merello G, et al. Wild-type transthyretin amyloidosis as a cause of heart failure with preserved ejection fraction. Eur Heart J. 2015; 36(38): 2585–2594. 
  2. Mohammed SF, Mirzoyev SA, Edwards WD et al. Left ventricular amyloid deposition in patients with heart failure and preserved ejection fraction. JACC Heart Fail. 2014; 2(2): 113–122
  3. Connors LH, Sam F, Skinner M et al. Heart Failure Due to Age-Related Cardiac Amyloid Disease Associated With Wild-Type Transthyretin: A Prospective, Observational Cohort Study. Circulation. 2016; 133(3): 282–290.
  4. Maurer MS, Hanna M, Grogan M, et al. Genotype and Phenotype of Transthyretin Cardiac Amyloidosis. J Am Coll Cardiol. 2016; 68(2): 161–172.
  5. González-López E, López-Sainz Á, Garcia-Pavia P. Diagnosis and Treatment of Transthyretin Cardiac Amyloidosis. Progress and Hope. Rev Esp Cardiol (Engl Ed). 2017;70(11):991‐1004.
  6. Nativi-Nicolau J, Maurer MS. Amyloidosis cardiomyopathy: update in the diagnosis and treatment of the most common types. Curr Opin Cardiol. 2018; 33(5): 571–579.
  7. Sperry BW, Reyes BA, Ikram A et al. Tenosynovial and Cardiac Amyloidosis in Patients Undergoing Carpal Tunnel Release. J Am Coll Cardiol. 2018; 72(17): 2040-2050. 
  8. Geller HI, Singh A, Alexander KM et al. Association Between Ruptured Distal Biceps Tendon and Wild-Type Transthyretin Cardiac Amyloidosis. JAMA. 2017; 318(10): 962–963.
  9. Galat A, Guellich A, Bodez D et al. Aortic stenosis and transthyretin cardiac amyloidosis: the chicken or the egg? Eur Heart J. 2016; 37(47): 3525–3531.
  10. Yanagisawa A, Ueda M, Sueyoshi T et al. Amyloid deposits derived from transthyretin in the ligamentum flavum as related to lumbar spinal canal stenosis. Mod Pathol. 2015; 28(2): 201–207.
  11. Witteles RM, Bokhari S, Damy T et al. Screening for Transthyretin Amyloid Cardiomyopathy in Everyday Practice. JACC Heart Fail. 2019; 7(8): 709–716.
PP-VYN-GBR-0888. October 2021

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