title: Different NT-proBNP circulating levels for different types of cardiac amyloidosis.
abstract: OBJECTIVE
  Several studies suggest that the N-terminal fragment of pro-brain natriuretic peptide levels are quite different in wild-type transthyretin (TTR)-related amyloidosis (ATTRwt) and mutated TTR-related amyloidosis (ATTRm) compared with immunoglobulin light-chain cardiac amyloidosis. Our aim was to test this hypothesis in a cohort of patients with different types of cardiac amyloidosis.
  
  
  METHODS
  Seventy patients with ATTRwt, ATTRm, and light-chain cardiac amyloidosis matched for left ventricular (LV) mass index were studied by standard echocardiography, tissue Doppler imaging, and plasmatic cardiac biomarkers.
  
  
  RESULTS
  Despite similar LV mass and renal function, patients with ATTR cardiac amyloidosis showed lower levels of N-terminal fragment of pro-brain natriuretic peptide than do light-chain amyloidosis ones, especially when expressed as a function of LV mass index.
  
  
  CONCLUSIONS
  Amyloidogenic light-chain-derived fibrils induce more severe myocardial dysfunction in light-chain amyloidosis than in ATTR, despite similar myocardial infiltration. Thus, the degree of cardiac dysfunction may be related not only to the amount of amyloid deposited, but also to qualitative differences among fibrils.
authors.affiliation: aRegional Amyloid Center bCytogenetics and Genetics Unit cHeart and Vessels Department, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Perfetto
authors.forename: Franco
authors.initials: F
authors.lastname: Bergesio
authors.forename: Elisa
authors.initials: E
authors.lastname: Grifoni
authors.forename: Alessia
authors.initials: A
authors.lastname: Fabbri
authors.forename: Gabriele
authors.initials: G
authors.lastname: Ciuti
authors.forename: Sabrina
authors.initials: S
authors.lastname: Frusconi
authors.forename: Paola
authors.initials: P
authors.lastname: Angelotti
authors.forename: Valentina
authors.initials: V
authors.lastname: Spini
authors.forename: Francesco
authors.initials: F
authors.lastname: Cappelli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000145:classification* / Q000503:physiopathology*; D015415:Biomarkers; D009202:Cardiomyopathies / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000097:blood*; D007558:Italy; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011228:Prealbumin / Q000235:genetics*; D012189:Retrospective Studies; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D007147:Immunoglobulin Light Chains; D010446:Peptide Fragments; D011228:Prealbumin; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain