Thorny path to the diagnosis of «amyloidosis of the heart»


DOI: https://dx.doi.org/10.18565/therapy.2022.4.119-125

Tarasova L.V., Dubova A.V., Dimitrieva O.V., Khripunova O.N.

1) I.N. Ulyanov Chuvash State University, Cheboksary; 2) Republican Cardiology Dispensary of the Ministry of Healthcare of the Chuvash Republic, Cheboksary
Abstract. One of the reasons for the development of restrictive cardiomyopathy is amyloidosis of the heart, leading to free, refractory to therapy heart failure. Despite the identified identified heart damage in amyloidosis, it is diagnosed quite late due to the absence of characteristic symptoms. Sometimes the diagnosis is verified according to the pathological and anatomical autopsy. The article describes a clinical case of systemic amyloidosis, which debuted with resistant heart failure and arrhythmias in the form of atrial fibrillation. Early screening for amyloidosis is very important as it allows for rapid initiation of specific therapy. The presented observation confirms the importance of early screening for amyloidosis, which allows timely initiation of specific therapy.
Keywords: AL-type amyloidosis, amyloidosis of the heart, refractory heart failure, restrictive cardiomyopathy, amyloid cardiomyopathy
Read entire article

Literature

1. Ахунова C.А., Барсуковская Т.А., Рафиков А.Ю., Сайфуллина Г.Б. Роль эхокардиографии в диагностике амилоидоза сердца. Практическая медицина. 2018; 1: 37–42. [Akhunova S.Yu., Barsukovskaya T.A., Rafikov A.Yu., Sayfullina G.B. Role of echocardiography in diagnosing cardiac amyloidosis. Prakticheskaya meditsina = Practical Medicine. 2018; 1: 37–42 (In Russ.)].


2. Лысенко (Козловская) Л.В., Рамеев В.В., Моисеев С.В. с соавт. Клинические рекомендации по диагностике и лечению системного амилоидоза. Клиническая фармакология и терапия. 2020; 1: 13–24. [Lysenko (Kozlovskaya) L.V., Rameev V.V., Moiseev S.V. et al. Clinical guidelines for diagnosis and treatment of systemic amyloidosis. Klinicheskaya farmakologiya i terapiya = Clinical Pharmacology and Therapy. 2020; 1: 13–24 (In Russ.)]. https://dx.doi.org/10.32756/0869-5490-2020-1-13-24.


3. Benson M.D., Buxbaum J.N., Eisenberg D.S. et al. Amyloid nomenclature 2018: recommendations by the International Society of Amyloidosis (ISA) nomenclature committee. Amyloid. 2018; 25(4): 215–19. https://dx.doi.org/10.1080/13506129.2018.1549825.


4. Falk R.H., Alexander K.M., Liao R., Dorbala S. AL (light-chain) cardiac amyloidosis: A review of diagnosis and therapy. J Am Coll Cardiol. 2016; 68(12): 1323–41. https://dx.doi.org/10.1016/j.jacc.2016.06.053.


5. Мясников Р.П., Андреенко Е.Ю., Кушунина Д.В. с соавт. Амилоидоз сердца: современные аспекты диагностики и лечения. Клиническая и экспериментальная хирургия. 2014; 4: 72–82. [Myasnikov R.P., Andreyenko E.Yu., Kushunina D.V. et al. Cardiac amyloidosis: modern aspects of diagnosis and treatment (clinical observation). Klinicheskaya i eksperimental’naya khirurgiya = Clinical and Experimental Surgery. 2014; 4: 72–82 (In Russ.)].


6. Palladini G., Milani P., Merlini G. Management of AL amyloidosis in 2020. Blood. 2020; 136(23): 2620–27. https://dx.doi.org/10.1182/blood.2020006913.


7. Резник Е.В., Нгуен Т.Л., Степанова Е.А. с соавт. Амилоидоз сердца: взгляд терапевта и кардиолога. Архивъ внутренней медицины. 2020; 6: 430–457. [Reznik E.V., Nguyen T.L., Stepanova E.A. et al. Cardiac amyloidosis: internist and cardiologist insight. Arkhiv vnutrenney meditsiny = The Russian Archives of Internal Medicine. 2020; 6: 430–457 (In Russ.)]. https://dx.doi.org/10.20514/2226-6704-2020-10-6-430-457.


8. Ash S., Shorer E., Ramgobin D. et al. Cardiac amyloidosis – a review of current literature for the practicing physician. Clin Cardiol. 2021; 44(3): 322–31. https://dx.doi.org/10.1002/clc.23572.


9. Martinez-Naharro A., Hawkins P.N., Fontana M. Cardiac amyloidosis. Clin Med (Lond). 2018; 18(Suppl 2): s30–s35. https://dx.doi.org/10.7861/clinmedicine.18-2-s30.


10. Стрелкова И.Е. Новая эра в лечении амилоидоза сердца: обзор конгресса кардиологов. Лечащий врач. 2021; 12: 90–94. [Strelkova I.E. A new era in treatment of cardiac amyloidosis: an overview of the congress of cardiology. Lechashchiy vrach = Attending Physician. 2021; 12: 90–94 (In Russ.)]. https://dx.doi.org/10.51793/OS.2021.24.12.013.


About the Autors

Larisa V. Tarasova, Dr. med. habil., head of the Department of faculty and hospital therapy, I.N. Ulyanov Chuvash State University, professor of the Department of internal diseases of the Medical institute of Surgut State University. Address: 428015, Cheboksary, 45 Moskovsky Avenue. E-mail: tlarisagast18@mail.ru
Alexandra V. Dubova, PhD in Medicine, associate professor of the Department of faculty and hospital therapy, I.N. Ulyanov Chuvash State University, deputy chief medical officer of Republican Cardiology Dispensary of the Ministry of Healthcare of the Chuvash Republic. Address: 428015, Cheboksary, 45 Moskovsky Avenue. E-mail: rkd@med.cap.ru
Olga V. Dimitrieva, postgraduate student of the Department of faculty and hospital therapy, I.N. Ulyanov Chuvash State University, professor of the Department of internal diseases of the Medical institute of Surgut State University, head of the Department of quality control and safety of medical activities, Republican Cardiology Dispensary of the Ministry of Healthcare of the Chuvash Republic. Address: 428015, Cheboksary, 45 Moskovsky Avenue. E-mail: salgarii@mail.ru
Olga N. Khripunova, head of advisory polyclinic – cardiologist at Republican Cardiology Dispensary of the Ministry of Healthcare of the Chuvash Republic. Address: 428020, Cheboksary, 29 «А» Fyodora Gladkova Str.


Similar Articles

Back to Content

Бионика Медиа