Many people living with transthyretin amyloid cardiomyopathy (ATTR-CM) experience not only heart-related symptoms, but also issues tied to the nervous system, like dizziness, digestive problems or bladder trouble. A recent study published in the journal Amyloid found that these symptoms — known as autonomic dysfunction — could also be a warning sign of more serious heart trouble ahead.
ATTR-CM happens when a protein in the body called transthyretin (TTR) misfolds and forms sticky clumps (called amyloid fibrils) that build up in the heart. But the same amyloid deposits can also affect the nerves that control automatic body functions, leading to issues with blood pressure regulation, digestion and bladder control.
In this study, researchers looked at 240 people with confirmed ATTR-CM, including both the inherited form and the more common age-related form (wild-type ATTR-CM). Each person completed a survey called COMPASS-31, which measures symptoms related to nerve problems, such as lightheadedness, stomach issues or vision changes. Based on their COMPASS-31 scores, participants were grouped into “high” or “low” symptom groups.
People with higher COMPASS-31 scores — meaning more nerve-related symptoms — had worse physical function, poorer quality of life and more advanced stages of heart disease. Additionally, they were more than four times as likely to be hospitalized for heart-related reasons during follow-up.
“These results support the concept that outcomes in patients with ATTR-CM are specifically impacted by autonomic dysfunction,” the researchers said.
Read more about ATTR-CM prognosis and staging
Previous research showed that nerve symptoms are more common in people with the inherited form of ATTR-CM. However, the results of this study suggest that even people with the age-related wild-type ATTR-CM — traditionally thought of as a heart-only disease — can have significant nerve symptoms that impact quality of life and heart-related outcomes.
These findings suggest that paying closer attention to nerve-related symptoms could help doctors identify patients at higher risk of heart complications and intervene earlier.
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