title: Emerging Advances in the Management of Cardiac Amyloidosis.
abstract: Amyloidosis is a disease in which proteins misfold, aggregate into fibrils, and deposit extracellularly disrupting organ architecture and function. There are two main types which affect the heart: light chain (AL) amyloidosis and transthyretin cardiac amyloidosis (ATTR). There is a misconception that cardiac amyloidosis has no effective treatment options. However, over the past decade, there has been extensive research and drug development. Outcomes are improving in AL amyloidosis with evolving chemotherapeutic regimens and novel monoclonal antibodies. In ATTR, therapies that decrease protein production, prevent dissociation, and promote clearance have the potential to slow or even halt a disease which is uniformly fatal. Selected patients may be candidates for heart and/or stem cell transplant and should be promptly referred to an experienced amyloid program. Herein, we discuss the emerging advances for the treatment of cardiac amyloidosis.
authors.affiliation: Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
authors.forename: Michael N
authors.initials: MN
authors.lastname: Vranian
authors.affiliation: Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
authors.forename: Brett W
authors.initials: BW
authors.lastname: Sperry
authors.affiliation: Department of Hematology and Oncology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Valent
authors.affiliation: Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. HANNAM@ccf.org.
authors.forename: Mazen
authors.initials: M
authors.lastname: Hanna
mesh_terms: D028227:Amyloid Neuropathies, Familial / Q000628:therapy; D000686:Amyloidosis / Q000628:therapy*; D000069286:Bortezomib / Q000627:therapeutic use; D009202:Cardiomyopathies / Q000628:therapy*; D005938:Glucocorticoids / Q000627:therapeutic use; D016027:Heart Transplantation; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000032:analysis; D033581:Stem Cell Transplantation / Q000379:methods
chemical_list: D005938:Glucocorticoids; D007147:Immunoglobulin Light Chains; D000069286:Bortezomib
keywords: Cardiac amyloidosis; Heart transplant; Light chain; Transthyretin