Nearly one in three older adults with certain health conditions — carpal tunnel syndrome, heart failure and/or left ventricular hypertrophy — may be living with undiagnosed transthyretin amyloid cardiomyopathy (ATTR-CM), according to a recent study published in European Heart Journal Supplements.
ATTR-CM happens when a protein in the body called transthyretin changes shape and forms clumps called amyloid deposits. These clumps build up in the heart, making it harder for the heart to pump blood properly.
The CAPTURE study involved over 1,200 people aged 65 or older who had carpal tunnel syndrome (which causes hand pain, numbness, tingling and weakness), heart failure or left ventricular hypertrophy (thickening of the heart muscle). Importantly, none of the participants had previously been diagnosed with ATTR-CM or other forms of amyloid cardiomyopathy.
Researchers carried out detailed testing, including bone scans and blood tests, to look for signs of amyloid buildup in the heart. Of the 1,085 participants who completed the full diagnostic process, 28% were diagnosed with ATTR-CM. Most patients (95%) had the wild-type form of the disease, which typically develops with age and is not inherited.
When cases of another form of amyloid cardiomyopathy — called amyloid light-chain (AL) cardiomyopathy — were included, the total rate of undiagnosed amyloid cardiomyopathy rose to 31%.
Read more about testing and diagnosis of ATTR-CM
“Such findings highlight the need for increased awareness, and possibly systematic screening in this population, even at primary care level,” the researchers said.
These results are similar to those from an earlier study called the AC-TIVE study, which also found a high rate of undiagnosed amyloid-related heart disease in participants aged 55 or older who showed certain warning signs on heart echocardiograms (ECGs). In that study, nearly one in four people (24%) had ATTR-CM and close to one in three (29%) had some form of amyloid cardiomyopathy.
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