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Amyloid
The Journal of Protein Folding Disorders
Volume 13, 2006 - Issue 3
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Original

Myocardial hypertrophy and function are related to age at onset in familial amyloidotic polyneuropathy

, M.D., Ph.D., , , &
Pages 154-159 | Published online: 06 Jul 2009
 

Abstract

Heart complications are frequently encountered in hereditary transthyretin amyloidosis. Lately, reports of late onset familial amyloid polyneuropathy (FAP) cases presenting with a phenotype similar to that observed in senile systemic amyloidosis have emerged. The aim of the present study was to evaluate morphological and functional features of the heart by echocardiography including myocardial strain measurements, and to compare the outcome for early with those of late onset FAP cases. Eighty-one biopsy and genetically proven FAP, ATTR Val30Met patients were investigated with two-dimensional, M-mode echocardiography and myocardial strain with special attention to inter-ventricular septum (IVS) thickness. IVS thickness was closely related to the age at onset (P < 0.0001), but not to duration of disease. Seventeen percent of the patients had severe left ventricular hypertrophy (IVS > 15 mm). These patients were all late onset cases and represented 39% of all of the late onset cases. Strain measurements were also closely related to IVS thickness and age at onset thereby signifying a decreased function of the heart muscle in late onset cases. From the present investigation it appears that late onset Swedish FAP-cases more readily develop cardiomyopathy with an increased IVS thickness. Different pathways for amyloid formation in the heart may operate in early and late onset cases.

Abbreviations
ATTR=

transthyretin amyloid

AV=

atrioventricular

FAP=

familial amyloidotic polyneuropathy

IVRT=

isovolumic relaxation time

IVS=

interventricular septum

LV=

left ventricular

RV=

right ventricular

SSA=

senile systemic amyloidosis

TTR=

transthyretin

Abbreviations
ATTR=

transthyretin amyloid

AV=

atrioventricular

FAP=

familial amyloidotic polyneuropathy

IVRT=

isovolumic relaxation time

IVS=

interventricular septum

LV=

left ventricular

RV=

right ventricular

SSA=

senile systemic amyloidosis

TTR=

transthyretin

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