ArticleJACC. CardioOncology2021
Concomitant Transthyretin Amyloidosis and Severe Aortic Stenosis in Elderly Indian Population: A Pilot Study.
Article in JACC. CardioOncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Prevalence of cardiac amyloidosis in screening studies: a systematic review and meta-analysis.ESC heart failure · 2026Pooled it
- Relative apical sparing of left ventricular longitudinal strain for the diagnosis of cardiac amyloidosis: a systematic review and meta-analysis.Open heart · 2026Pooled it
- Epidemiology of transthyretin (ATTR) amyloidosis: a systematic literature review.Orphanet journal of rare diseases · 2025Pooled it
- Redefining the epidemiology of cardiac amyloidosis. A systematic review and meta-analysis of screening studies.European journal of heart failure · 2022Pooled it
- Red Flags, Prognostic Impact, and Management of Patients With Cardiac Amyloidosis and Aortic Valve Stenosis: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2022Pooled it
- Expert Consensus and Clinical Pathway Recommendations for Transthyretin Amyloid Cardiomyopathy in Malaysia.International journal of heart failure · 2026Review
- Association Between Severe Aortic Stenosis and Amyloid Deposition in the Myocardium of Patients With Wild-Type Transthyretin Cardiac Amyloidosis.Circulation reports · 2026Article
- Tracking a patient with no technetium-99m-pyrophosphate myocardial uptake at surgical valve replacement for aortic stenosis.Journal of geriatric cardiology : JGC · 2025Article
- Transthyretin amyloid cardiomyopathy in aortic stenosis patients scheduled for transcatheter aortic valve implantation.ESC heart failure · 2025Article
- A Tale of Two Diseases: Decoding Aortic Stenosis and Cardiac Amyloidosis.Journal of clinical medicine · 2025Review
- Evolving Strategies in Cardiac Amyloidosis: From Mechanistic Discoveries to Diagnostic and Therapeutic Advances.Cardiology clinics · 2025Review
- Etiologies and predictors of mortality in an all-comer population of patients with non-ischemic heart failure.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Article
- The prognostic value of artificial intelligence to predict cardiac amyloidosis in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement.European heart journal. Digital health · 2024Article
- Screening for Occult Transthyretin Amyloidosis in Patients with Severe Aortic Stenosis and Amyloid Red Flags.Journal of clinical medicine · 2024Article
- Isolated Valve Amyloid Deposition in Aortic Stenosis: Potential Clinical and Pathophysiological Relevance.International journal of molecular sciences · 2024Article
- Valvular heart disease in patients with cardiac amyloidosis.Heart failure reviews · 2024Review
- Valvular heart disease and cardiomyopathy: reappraisal of their interplay.Nature reviews. Cardiology · 2024Review
- Cardiac Amyloidosis and Valvular Heart Disease.Journal of clinical medicine · 2023Review
- Valve disease in cardiac amyloidosis: an echocardiographic score.The international journal of cardiovascular imaging · 2023Article
- Transthyretin derived amyloid deposits in the atrium and the aortic valve: insights from multimodality evaluations and mid-term follow up.BMC cardiovascular disorders · 2023Article
Corrections and comments
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Authors and funding
19 authors.
Funding
Abstract
backgroundPrevalence of both degenerative severe aortic stenosis (AS) and transthyretin cardiac amyloidosis (ATTR-CA) increases with age. Dual disease (AS+myocardial ATTR-CA) occurs in significant proportion of patients undergoing surgical aortic valve replacement (SAVR).
objectivesThis study aimed to determine the prevalence of ATTR-CA in severe AS in the Indian population, identify noninvasive predictors of its diagnosis, and understand its impact on prognosis.
methodsSymptomatic severe AS patients aged ≥65 years undergoing SAVR were enrolled. ATTR-CA diagnosis was based on preoperative 99m-technetium pyrophosphate (PYP) scan and intraoperatively obtained basal interventricular septum biopsy for myocardial ATTR-CA, and excised native aortic valve for isolated valvular ATTR-CA. Primary amyloidosis was excluded by serum/urine protein electrophoresis with serum immunofixation.
resultsSAVR was performed in 46 AS patients (age 70 ± 5 years, 70% men). PYP scan was performed for 32 patients, with significant PYP uptake in 3 (n = 3 of 32, 9.4%), suggestive of myocardial ATTR-CA. On histopathological examination, none of the interventricular septum biopsy specimens had amyloid deposits, whereas 33 (71.7%) native aortic valves showed amyloid deposits, of which 19 (57.6%) had transthyretin deposition suggestive of isolated valvular amyloidosis. Noninvasive markers of dual disease included low myocardial contraction fraction (median [interquartile range], 28.8% [23.8% to 39.1%] vs 15.3% [9.3% to 16.1%];
conclusionsDual disease is not uncommon in India. Isolated valvular amyloidosis in severe AS is much more common.
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