Cardiac Amyloidosis Screening in Aortic Stenosis: Prevalence, Imaging Strategy and Its Effect on Valve Decisions
DOI:
https://doi.org/10.5281/zenodo.22386631Abstract
Severe aortic stenosis (AS) and transthyretin cardiac amyloidosis (ATTR-CA) share a patient: elderly, often frail,
and increasingly referred for transcatheter aortic valve replacement (TAVR). For years the two conditions were
considered separately, with amyloidosis treated as a rare confounder to be excluded rather than a common fellow
traveller to be actively sought. Bone-avid scintigraphy tracers -- 99mTc-pyrophosphate (PYP) in North America,
99mTc-DPD in Europe -- changed that picture by making non-invasive diagnosis of ATTR-CA practical at scale, and a
series of screening studies in AS and TAVR cohorts has since converged on a consistent, uncomfortable finding: concomitant
ATTR-CA is common, not rare, once a valve team actually looks for it.
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