Ronald Witteles, MD, Stanford University, Stanford, CA, discusses challenges that remain in the diagnosis of transthyretin (ATTR) amyloidosis. Diagnosis of this disease can be straightforward: from an initial suspicion, a monoclonal paraprotein assessment to rule out light chain (AL) amyloidosis and a technetium scintigraphy are conducted, and additional genetic testing can determine the exact mutation responsible for the disease. However, raising the initial suspicion poses a challenge, as other conditions that co-exist with ATTR amyloidosis, such as carpal tunnel syndrome and lumbar spinal stenosis, are often overlooked by cardiologists. Seeing that testing is non-invasive, accurate, and that treatment options can greatly reduce disease burden, it is important to inform doctors and establish basic findings and demographics which should trigger an evaluation for ATTR amyloidosis. This interview took place at the XIX International Symposium on Amyloidosis (ISA) in Rochester, MN.

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Dr. Justin Grodin, a cardiologist and co-director of the UT Southwestern Multidisciplinary Amyloidosis Program, goes through the diagnostic process for AL and ATTR cardiac amyloidosis. He discusses key differences between AL and ATTR, and how typing of amyloidosis is paramount to consider in order to subsequently develop a treatment plan. He goes through a diagnostic algorithm to help clinicians arrive at an accurate diagnosis. Finally, he stresses the importance of genetic testing and counseling for ATTR to differentiate between wild-type and hereditary, as well as identifying the specific genetic variant.

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0:00 - Background Info
0:51 - Clinical Features
2:39 - Diagnosis
3:49 - Treatment
4:36 - Prognosis

Kavita Sharma, Director of Heart Failure and Cardiac Transplantation, presents a patient case on amyloidosis. She provides an explanation of amyloidosis along with new treatment and therapy options available at Johns Hopkins. She discusses the patient's journey and how the severity of his case led to a combined heart and kidney transplant.

18 october 19h30CET 13h30ET

Speakers:

Michelle Kittleson
Director of Education in Heart Failure and Transplantation, Professor of Medicine, Smidt Heart Institute , Cedars-Sinai, USA
Presentation: Amyloidosis: Red Flags and Clinical Clues

Benjamin Essayagh
Division of Cardiovascular Disease, Mayo Clinic, Minnesota, USA & Cannes Hospital, France
Presentation: The Role of Imaging Studies in the Diagnosis of Cardiac Amyloidosis

Frederick Ruberg
Associate Chief, Academic Affairs, Section of Cardiovascular Medicine
Associate Professor of Medicine and Radiology, Boston University School of Medicine, USA
Presentation: The Diagnostic Algorithm: The Role of the Monoclonal Light Chain Screen, Genetic Testing, and Biopsies

Mathew Maurer
Columbia University Irving Medical Center, New York Presbyterian Hospital, USA
Presentation: Treatment of Transthyretin Amyloidosis: Current Therapies and Future Promise

Moderators:

Michelle Kittleson
Director of Education in Heart Failure and Transplantation, Professor of Medicine, Smidt Heart Institute , Cedars-Sinai
Presentation: Amyloidosis: Red Flags and Clinical Clues

Alexandru Mischie, M.D., PhD, FAHA, FESC
Head of Interventional Cardiology Department Centre Hospitalier Montlucon, France
Chair of the Tele-Cardiology Working Group ISfTeH

Jeffrey Zonder, MD from the Karmanos Cancer Institute in Detroit, MI presents this webinar on current amyloidosis treatments.