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The purpose of this study is to establish a differential diagnosis algorithm targeted towards the two most frequent subtypes of CA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We prospectively included all consecutive patients with ATTR and AL evaluated between 2018 and 2022 in two centres in a score derivation cohort and a different validation sample. All patients had a complete clinical, biomarker, electrocardiographic, and imaging evaluation. Confirmation of the final diagnosis with amyloid typing was performed according to the current international recommendations. The study population included 81 patients divided into two groups: ATTR (group 1, n = 32: 28 variant and 4 wild type) and AL (group 2, n = 49). ATTR patients were younger (50.7 \u00b1 13.9 vs. 60.2 \u00b1 7.3 years, P = 0.0001), and significantly different in terms of NT-proBNP [ATTR: 1472.5 ng\/L (97\u20134218.5) vs. AL 8024 ng\/L (3058\u201314 069) P = 0.001], hs-cTn I [ATTR: 10 ng\/L (4\u201320) vs. AL 78 ng\/L (32\u2013240), P = 0.0002], GFR [ATTR 95.4 mL\/min (73.8\u2013105.3) vs. AL: 68.4 mL\/min (47.8\u201387.4) P = 0.003]. At similar left ventricular (LV) wall thickness and ejection fraction, the ATTR group had less frequently pericardial effusion (ATTR: 15% vs. AL: 33% P = 0.0027), better LV global longitudinal strain (ATTR: \u221213.1% \u00b1 3.5 vs. AL: \u22129.1% \u00b1 4.3 P = 0.04), RV strain (ATTR: \u221221.9% \u00b1 6.2 vs. AL: \u221216.8% \u00b1 6 P = 0.03) and better reservoir function of the LA strain (ATTR: 22% \u00b1 12 vs. AL: 13.6% \u00b1 7.8 P = 0.02). Cut-off points were calculated based on the Youden method. We attributed to 2 points for parameters having an AUC &amp;gt; 0.75 (NT-proBNP AUC 0.799; hs-cTnI AUC 0.87) and 1 point for GFR (AUC 0.749) and TTE parameters (GLS AUC 0.666; RV FWS AUC 0.649, LASr AUC 0.643). A score of equal or more than 4 points has been able to differentiate between AL and ATTR (sensitivity 80%, specificity 62%, AUC = 0.798). The differential diagnosis score system was applied to the validation cohort of 52 CA patients showing a sensitivity of 81% with specificity of 77%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CA is a complex entity and requires extensive testing for a positive diagnosis. This study highlights a series of non-invasive checkpoints, which can be useful in guiding the decision-making process towards a more accurate and rapid differential diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14852","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T01:38:26Z","timestamp":1715909906000},"page":"2825-2834","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Cardiac Amyloidosis is Not a Single Disease: A Multiparametric Comparison Between the Light Chain and Transthyretin Forms"],"prefix":"10.1093","volume":"11","author":[{"given":"Gabriela","family":"Neculae","sequence":"first","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy , Bucharest ,","place":["Romania"]},{"name":"Expert Centre for Rare Cardiovascular Diseases, Prof. Dr. C.C. 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Iliescu Emergency Institute for Cardiovascular Diseases , Bucharest ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea","family":"Jercan","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy , Bucharest ,","place":["Romania"]},{"name":"Department of Hematology, Fundeni Clinical Institute , Bucharest ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorina","family":"B\u0103deli\u021b\u0103","sequence":"additional","affiliation":[{"name":"Department of Hematology, Fundeni Clinical Institute , Bucharest ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherina","family":"Tjahjadi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Centre , Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirela","family":"Draghici","sequence":"additional","affiliation":[{"name":"Department of Neurology, Fundeni Clinical Institute , Bucharest ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudiu","family":"Stan","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Fundeni Clinical Institute , Bucharest ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen J.","family":"Bax","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Centre , Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan A.","family":"Popescu","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy , Bucharest ,","place":["Romania"]},{"name":"Expert Centre for Rare Cardiovascular Diseases, Prof. Dr. C.C. 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