{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:44:15Z","timestamp":1790790255962,"version":"4.1.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":2002,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,6,26]],"date-time":"2020-06-26T00:00:00Z","timestamp":1593129600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Advances have been made over the last decade in the management of cardiac amyloidosis (CA), but a delayed diagnosis is still common. The aim of this study was to describe the journey to CA diagnosis from initial clinical and to analyse time to diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Between January 2001 and May 2019, 270 consecutive patients with CA diagnosed at Toulouse University Hospital were retrospectively included in this cross-sectional study: 111 (41%) light chain amyloidosis, 122 (45%) wild-type transthyretin amyloidosis, and 37 (14%) hereditary transthyretin amyloidosis.<\/jats:p>\n                    <jats:p>CA onset occurred mostly with dyspnoea (50%) or systematic follow-up (10%). The cardiologist was the first line specialist in 68% of patients, followed by the nephrologist (9%) and neurologist (8%). Patients encountered a median (minimum\u2013maximum) number of two (1\u20137) physician specialists and performed a median (minimum\u2013maximum) number of three (1\u20138) tests before diagnosis. Median delay between symptom onset and CA diagnosis was 8 [IQR 5\u201314], 10 [IQR 3\u201334], and 18 [IQR 4\u201349] months, respectively, in light chain amyloidosis, wild-type transthyretin amyloidosis, and hereditary transthyretin amyloidosis subgroups (P = .060). Having performed electromyography or spirometry was associated with a longer delay in diagnosis in the overall population: odds ratio = 1.13; 95% confidence interval 1.02 to 1.24; and odds ratio = 1.13; 1.03 to 1.24, respectively, probably due to non-specific initial symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CA is a protean disease with various first line specialists causing a diagnostic wandering despite increasing medical community awareness. It requires a multidisciplinary specialist care networks to educate and manage symptoms and therapies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.12793","type":"journal-article","created":{"date-parts":[[2020,6,26]],"date-time":"2020-06-26T04:30:51Z","timestamp":1593145851000},"page":"2418-2430","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Gateway and Journey of Patients with Cardiac Amyloidosis"],"prefix":"10.1093","volume":"7","author":[{"given":"Daniel","family":"Dang","sequence":"first","affiliation":[{"name":"Department of Cardiology, Rangueil University Hospital , Toulouse ,","place":["France"]},{"name":"Cardiac Imaging Center, Toulouse University Hospital , Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Fournier","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rangueil University Hospital , Toulouse ,","place":["France"]},{"name":"Cardiac Imaging Center, Toulouse University Hospital , Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eve","family":"Cariou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rangueil University Hospital , Toulouse ,","place":["France"]},{"name":"Cardiac Imaging Center, Toulouse University Hospital , Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Huart","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Referral Center for Rare Diseases, Rangueil University Hospital , Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Ribes","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Referral Center for Rare Diseases, Rangueil University Hospital , Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Cintas","sequence":"additional","affiliation":[{"name":"Department of Neurology, Purpan University Hospital , Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murielle","family":"Roussel","sequence":"additional","affiliation":[{"name":"Department of Hematology, IUC Oncopole , Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magali","family":"Colombat","sequence":"additional","affiliation":[{"name":"Department of Pathology, IUC Oncopole , Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoan","family":"Lavie-Badie","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rangueil University Hospital , Toulouse ,","place":["France"]},{"name":"Cardiac Imaging Center, Toulouse University Hospital , Toulouse 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