{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:49:54Z","timestamp":1787068194566,"version":"build-2736575974"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T00:00:00Z","timestamp":1645660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The aim of this study is to evaluate the implementation of the cardiac amyloidosis (CA) clinical pathway on awareness among referring cardiologists, diagnostic delay, and severity of CA at diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Patients with CA were retrospectively included in this study and divided into two periods: pre-implementation of the CA clinical pathway (2007\u201318; T1) and post-implementation (2019\u201320; T2). Patients\u2019 and disease characteristics were extracted from electronic health records and compared. In total, 113 patients (mean age 67.8 \u00b1 8.5 years, 26% female) were diagnosed with CA [T1 (2007\u201318): 56; T2 (2019\u201320): 57]. The number of CA diagnoses per year has increased over time. Reasons for referral changed over time, with increased awareness of right ventricular hypertrophy (9% in T1 vs. 36% in T2) and unexplained heart failure with preserved ejection fraction (22% in T1 vs. 38% in T2). Comparing T1 with T2, the diagnostic delay also improved (14 vs. 8 months, P &amp;lt; 0.01), New York Heart Association Class III (45% vs. 23%, P = 0.03), and advanced CA stage (MAYO\/Gillmore Stage III\/IV; 61% vs. 33%, P \u2264 0.01) at time of diagnosis decreased.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>After implementation of the CA clinical pathway, the awareness among referring cardiologists improved, diagnostic delay was decreased, and patients had less severe CA at diagnosis. Further studies are warranted to assess the prognostic impact of CA clinical pathway implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjopen\/oeac011","type":"journal-article","created":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T10:10:15Z","timestamp":1645697415000},"source":"Crossref","is-referenced-by-count":30,"title":["Evaluation of the cardiac amyloidosis clinical pathway implementation: a real-world experience"],"prefix":"10.1093","volume":"2","author":[{"given":"Maaike","family":"Brons","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Medical Center Utrecht , PO Box 85500, 3508 GA Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven A","family":"Muller","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Utrecht , PO Box 85500, 3508 GA Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frans H","family":"Rutten","sequence":"additional","affiliation":[{"name":"Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University , PO Box 85500, 3508 GA Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon G","family":"van der Meer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Utrecht , PO Box 85500, 3508 GA Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander F J E","family":"Vrancken","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medical Center Utrecht , PO Box 85500, 3508 GA Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique C","family":"Minnema","sequence":"additional","affiliation":[{"name":"Department of Haematology, University Medical Center Utrecht , PO Box 85500, 3508 GA Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette F","family":"Baas","sequence":"additional","affiliation":[{"name":"Department of Genetics, University Medical Center Utrecht , PO Box 85500, 3508 GA Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Folkert W","family":"Asselbergs","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Utrecht , PO Box 85500, 3508 GA Utrecht, The Netherlands"},{"name":"Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London , Gower Street, London WC1E 6BT, UK"},{"name":"Institute of Health Informatics, Faculty of Population Health Sciences, University College London , 222 Euston Rd, Kings Cross, London NW1 2DA , 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