Cardiac Amyloidosis in Heart Failure Patients With Preserved Ejection Fraction

What this Trial Is About

Heart failure with preserved ejection fraction (HFpEF) is a complex condition that accounts for half of all heart failure cases and has various underlying causes. Diagnosing HFpEF involves recognizing heart failure symptoms, a normal left ventricular ejection fraction (LVEF), and signs of diastolic dysfunction. Recent major clinical trials have not found effective treatments for HFpEF, partly because of its diverse causes. One possible cause is wild-type transthyretin amyloidosis (ATTRwt), a condition where misfolded transthyretin protein deposits in the heart, which may be underdiagnosed in HFpEF patients, especially in Taiwan and Asia. This observational study aims to determine how common ATTRwt is among elderly HFpEF patients in Taiwan. Researchers will recruit 260 patients aged 60 or older, or 50 and older with certain risk factors like carpal tunnel syndrome or spinal stenosis. Participants will undergo heart imaging using 99mTc-PYP scintigraphy and blood tests to detect amyloid deposits. If the scan is positive, additional urine and blood tests for monoclonal light chains and genetic testing for transthyretin mutations will be performed. Existing test results from the last six months can be used to avoid repeat procedures. Participants will have routine assessments including NTproBNP blood tests, ECG, and echocardiography. Medical records will be reviewed by blinded physicians to collect clinical data. The main outcome measured is the percentage of HFpEF patients with ATTRwt in Taiwan. The study will also compare clinical and echocardiographic features between ATTRwt-positive and ATTRwt-negative patients. Participants will be involved throughout the study duration, with imaging and laboratory tests performed as part of their evaluation.

Cardiac Amyloidosis in HFpEF