Histopathological and Immunohistochemical Characteristics of Different Types of Cardiac Amyloidosis
Cardiac involvement is the most important factor determining prognosis in patients with systemic amyloidosis. This retrospective observational study of 98 patients with amyloidosis was undertaken to assess the amyloid types that are most likely to affect the heart, describe histopathological and cli...
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| Veröffentlicht in: | International journal of molecular sciences 2024-10, Vol.25 (19), p.10667 |
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| creator | Gioeva, Zarina V Mikhaleva, Liudmila M Gutyrchik, Nikita A Volkov, Alexey V Popov, Mikhail A Shakhpazyan, Nikolay K Pechnikova, Valentina V Midiber, Konstantin Y Reznik, Elena V Kakturskij, Lev V |
| description | Cardiac involvement is the most important factor determining prognosis in patients with systemic amyloidosis. This retrospective observational study of 98 patients with amyloidosis was undertaken to assess the amyloid types that are most likely to affect the heart, describe histopathological and clinical features of cardiac amyloidosis, and estimate the number of cases not diagnosed clinically prior to death. All cases were divided into two groups based on the method of examination. The first group included 46 patients with cardiac amyloidosis revealed via endomyocardial biopsies (EMBs), and the second group included 52 amyloidosis patients who did not undergo EMBs, in whom cardiac involvement was identified only at autopsy. The EMBs demonstrated that AL amyloidosis was detected in 21 (46%) specimens, ATTR amyloid in 24 cases (52%), and AA amyloid in 1 case (2%). The autopsy reports defined 15 (46%) cases of AL amyloidosis, 21 (40%) of ATTR and 16 (31%) of AA amyloidosis. It should be noted that a clinical diagnosis of ATTR amyloidosis was made only in 9.5% of patients from the autopsy group, suggesting that ATTR may be an underdiagnosed cause of heart failure in elderly patients. The most intense amyloid deposits were determined in biopsy and autopsy specimens of patients with AL kappa amyloidosis, underlying a poorer prognosis. |
| doi_str_mv | 10.3390/ijms251910667 |
| format | Article |
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This retrospective observational study of 98 patients with amyloidosis was undertaken to assess the amyloid types that are most likely to affect the heart, describe histopathological and clinical features of cardiac amyloidosis, and estimate the number of cases not diagnosed clinically prior to death. All cases were divided into two groups based on the method of examination. The first group included 46 patients with cardiac amyloidosis revealed via endomyocardial biopsies (EMBs), and the second group included 52 amyloidosis patients who did not undergo EMBs, in whom cardiac involvement was identified only at autopsy. The EMBs demonstrated that AL amyloidosis was detected in 21 (46%) specimens, ATTR amyloid in 24 cases (52%), and AA amyloid in 1 case (2%). The autopsy reports defined 15 (46%) cases of AL amyloidosis, 21 (40%) of ATTR and 16 (31%) of AA amyloidosis. It should be noted that a clinical diagnosis of ATTR amyloidosis was made only in 9.5% of patients from the autopsy group, suggesting that ATTR may be an underdiagnosed cause of heart failure in elderly patients. The most intense amyloid deposits were determined in biopsy and autopsy specimens of patients with AL kappa amyloidosis, underlying a poorer prognosis.</description><identifier>ISSN: 1422-0067</identifier><identifier>ISSN: 1661-6596</identifier><identifier>EISSN: 1422-0067</identifier><identifier>DOI: 10.3390/ijms251910667</identifier><identifier>PMID: 39408996</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Adult ; Age ; Aged ; Aged, 80 and over ; Amyloid - metabolism ; Amyloidosis ; Amyloidosis - metabolism ; Amyloidosis - pathology ; Autopsies ; Autopsy ; Biopsy ; Cardiomyocytes ; Cardiomyopathies - metabolism ; Cardiomyopathies - pathology ; Cardiomyopathy ; Complications and side effects ; Correlation analysis ; Development and progression ; Diagnosis ; Female ; Heart diseases ; Heart failure ; Histology ; Humans ; Immunoglobulin Light-chain Amyloidosis - metabolism ; Immunoglobulin Light-chain Amyloidosis - pathology ; Immunohistochemistry ; Male ; Middle Aged ; Multiple myeloma ; Myocardium - metabolism ; Myocardium - pathology ; Patients ; Prognosis ; Proteins ; Retrospective Studies ; Risk factors ; Serum Amyloid A Protein</subject><ispartof>International journal of molecular sciences, 2024-10, Vol.25 (19), p.10667</ispartof><rights>COPYRIGHT 2024 MDPI AG</rights><rights>2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 by the authors. 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c330t-4f0872125c46b4082eb76d731189cb00eb953bbf136c1d34e7b993c6543743483</cites><orcidid>0000-0002-2352-278X ; 0000-0001-7479-418X ; 0000-0003-3386-7746 ; 0000-0002-1426-968X ; 0000-0001-5896-4556 ; 0000-0002-5611-3990 ; 0000-0003-2052-914X ; 0000-0002-5456-8692 ; 0000-0002-0316-8410 ; 0000-0001-7896-2080</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11476653/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11476653/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39408996$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gioeva, Zarina V</creatorcontrib><creatorcontrib>Mikhaleva, Liudmila M</creatorcontrib><creatorcontrib>Gutyrchik, Nikita A</creatorcontrib><creatorcontrib>Volkov, Alexey V</creatorcontrib><creatorcontrib>Popov, Mikhail A</creatorcontrib><creatorcontrib>Shakhpazyan, Nikolay K</creatorcontrib><creatorcontrib>Pechnikova, Valentina V</creatorcontrib><creatorcontrib>Midiber, Konstantin Y</creatorcontrib><creatorcontrib>Reznik, Elena V</creatorcontrib><creatorcontrib>Kakturskij, Lev V</creatorcontrib><title>Histopathological and Immunohistochemical Characteristics of Different Types of Cardiac Amyloidosis</title><title>International journal of molecular sciences</title><addtitle>Int J Mol Sci</addtitle><description>Cardiac involvement is the most important factor determining prognosis in patients with systemic amyloidosis. This retrospective observational study of 98 patients with amyloidosis was undertaken to assess the amyloid types that are most likely to affect the heart, describe histopathological and clinical features of cardiac amyloidosis, and estimate the number of cases not diagnosed clinically prior to death. All cases were divided into two groups based on the method of examination. The first group included 46 patients with cardiac amyloidosis revealed via endomyocardial biopsies (EMBs), and the second group included 52 amyloidosis patients who did not undergo EMBs, in whom cardiac involvement was identified only at autopsy. The EMBs demonstrated that AL amyloidosis was detected in 21 (46%) specimens, ATTR amyloid in 24 cases (52%), and AA amyloid in 1 case (2%). The autopsy reports defined 15 (46%) cases of AL amyloidosis, 21 (40%) of ATTR and 16 (31%) of AA amyloidosis. It should be noted that a clinical diagnosis of ATTR amyloidosis was made only in 9.5% of patients from the autopsy group, suggesting that ATTR may be an underdiagnosed cause of heart failure in elderly patients. The most intense amyloid deposits were determined in biopsy and autopsy specimens of patients with AL kappa amyloidosis, underlying a poorer prognosis.</description><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Amyloid - metabolism</subject><subject>Amyloidosis</subject><subject>Amyloidosis - metabolism</subject><subject>Amyloidosis - pathology</subject><subject>Autopsies</subject><subject>Autopsy</subject><subject>Biopsy</subject><subject>Cardiomyocytes</subject><subject>Cardiomyopathies - metabolism</subject><subject>Cardiomyopathies - pathology</subject><subject>Cardiomyopathy</subject><subject>Complications and side effects</subject><subject>Correlation analysis</subject><subject>Development and progression</subject><subject>Diagnosis</subject><subject>Female</subject><subject>Heart diseases</subject><subject>Heart failure</subject><subject>Histology</subject><subject>Humans</subject><subject>Immunoglobulin Light-chain Amyloidosis - 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This retrospective observational study of 98 patients with amyloidosis was undertaken to assess the amyloid types that are most likely to affect the heart, describe histopathological and clinical features of cardiac amyloidosis, and estimate the number of cases not diagnosed clinically prior to death. All cases were divided into two groups based on the method of examination. The first group included 46 patients with cardiac amyloidosis revealed via endomyocardial biopsies (EMBs), and the second group included 52 amyloidosis patients who did not undergo EMBs, in whom cardiac involvement was identified only at autopsy. The EMBs demonstrated that AL amyloidosis was detected in 21 (46%) specimens, ATTR amyloid in 24 cases (52%), and AA amyloid in 1 case (2%). The autopsy reports defined 15 (46%) cases of AL amyloidosis, 21 (40%) of ATTR and 16 (31%) of AA amyloidosis. It should be noted that a clinical diagnosis of ATTR amyloidosis was made only in 9.5% of patients from the autopsy group, suggesting that ATTR may be an underdiagnosed cause of heart failure in elderly patients. 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| source | MDPI - Multidisciplinary Digital Publishing Institute; MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Adult Age Aged Aged, 80 and over Amyloid - metabolism Amyloidosis Amyloidosis - metabolism Amyloidosis - pathology Autopsies Autopsy Biopsy Cardiomyocytes Cardiomyopathies - metabolism Cardiomyopathies - pathology Cardiomyopathy Complications and side effects Correlation analysis Development and progression Diagnosis Female Heart diseases Heart failure Histology Humans Immunoglobulin Light-chain Amyloidosis - metabolism Immunoglobulin Light-chain Amyloidosis - pathology Immunohistochemistry Male Middle Aged Multiple myeloma Myocardium - metabolism Myocardium - pathology Patients Prognosis Proteins Retrospective Studies Risk factors Serum Amyloid A Protein |
| title | Histopathological and Immunohistochemical Characteristics of Different Types of Cardiac Amyloidosis |
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