Carolina Tennyson, assistant professor, coauthored "Understanding and recognizing cardiac amyloidosis" for the Journal of the American Academy of Physician Assistants with Todd McVeigh of Duke Hospital. 

Abstract

Cardiac amyloidosis is an infiltrative abnormality that causes myocardial thickening and dysfunction. Historically, it has been underrecognized as a cause of heart failure and was often misdiagnosed. In the past decade, the cardiology community has improved the understanding of the subtypes of these protein-based infiltrates and how they play a role in heart failure. This article reviews the pathophysiology, presentation, diagnosis, and management of cardiac amyloidosis.

Amyloidoses are a group of degenerative diseases characterized by protein abnormalities that cause damaging fibrous deposits throughout the body. The most recognized diseases in this group are those affecting the nervous system, namely Alzheimer and Parkinson diseases. However, clinical research and literature in the past decade have shown increasing awareness of cardiac dysfunction caused by amyloidosis. Investigations have shown that cardiac amyloidosis and its resulting toxic-infiltrative cardiomyopathy are much more common than previously believed and the condition is an underrecognized cause of heart failure, particularly diastolic heart failure. This article discusses the effects of amyloidosis on the heart and how to recognize it in clinical practice.

Nomenclature for amyloidosis uses the letter A for amyloid, followed by letter(s) indicating the main precursor protein being deposited. Light-chain amyloidosis is denoted AL (A for amyloid; L for light chain), and transthyretin amyloidosis is abbreviated ATTR (A for amyloid; TTR for transthyretin).