The Diagnostic Conundrum: Recognizing ATTR-CM in HFpEF

Transthyretin-mediated amyloid cardiomyopathyexternal link, opens in a new tab (ATTR-CM) and heart failure with preserved ejection fraction (HFpEF) caused by other factors tend to present in similar ways. While ATTR-CM is a known cause of HFpEF, the disease is widely unrecognized in this patient population. Overlooking ATTR-CM in patients presenting with HFpEF deprives them of timely, disease-modifying therapies capable of halting amyloid deposition.

HFpEF and ATTR-CM: The Similarities

Both patients with regular HFpEF and those with ATTR-CM may present with increased left ventricular wall thickness, preserved ejection fraction, diastolic dysfunction, congestion, elevated natriuretic peptide levels, and exercise intolerance.

Importantly, HFpEF lies behind more than half of all heart failure cases. “With the growing population age, obesity, hypertension, and diabetes, the prevalence is predicted to rise,” Magdi and colleagues wrote in a study published in the American Journal of Cardiovascular Disease.