{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T02:13:25Z","timestamp":1793844805030,"version":"4.6.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"24","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,6,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Wild-type transthyretin amyloidosis (ATTRwt) is mostly considered a disease predominantly of elderly male, characterized by concentric LV hypertrophy, preserved LVEF, and low QRS voltages. We sought to describe the characteristics of a large cohort of ATTRwt patients to better define the disease.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Clinical findings of consecutive ATTRwt patients diagnosed at 2 centres were reviewed. ATTRwt was diagnosed histologically or non-invasively (LV hypertrophy \u226512\u2009mm, intense cardiac uptake at 99mTc-DPD scintigraphy and AL exclusion). Mutations in TTR were excluded in all cases. The study cohort comprised 108 patients (78.6 \u00b1 8 years); 67 (62%) diagnosed invasively and 41 (38%) non-invasively. Twenty patients (19%) were females. An asymmetric hypertrophy pattern was observed in 25 (23%) patients. Mean LVEF was 52 \u00b1 14%, with 39 patients (37%) showing a LVEF\u2009&amp;lt;\u200950%. Atrial fibrillation (56%) and a pseudo-infarct pattern (63%) were the commonest ECG findings. Only 22 patients fulfilled QRS low-voltage criteria while 10 showed LV hypertrophy on ECG. Although heart failure was the most frequent profile leading to diagnosis (68%), 7% of individuals presented with atrioventricular block and 11% were diagnosed incidentally. Almost one third (35; 32%) were previously misdiagnosed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The clinical spectrum of ATTRwt is heterogeneous and differs from the classic phenotype: women are affected in a significant proportion; asymmetric LV hypertrophy and impaired LVEF are not rare and only a minority have low QRS voltages. Clinicians should be aware of the broad clinical spectrum of ATTRwt to correctly identify an entity for which a number of disease-modifying treatments are under investigation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehx043","type":"journal-article","created":{"date-parts":[[2017,1,30]],"date-time":"2017-01-30T13:27:49Z","timestamp":1485782869000},"page":"1895-1904","source":"Crossref","is-referenced-by-count":345,"title":["Clinical characteristics of wild-type transthyretin cardiac amyloidosis: disproving myths"],"prefix":"10.1093","volume":"38","author":[{"given":"Esther","family":"Gonz\u00e1lez-L\u00f3pez","sequence":"first","affiliation":[{"name":"1Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, Madrid, Spain"},{"name":"2Myocardial Biology Programme, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain"},{"name":"3Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Cardiovasculares (CIBERCV)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Gagliardi","sequence":"additional","affiliation":[{"name":"4Institute of Cardiology, University of Bologna and S Orsola-Malpighi Hospital, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Dominguez","sequence":"additional","affiliation":[{"name":"1Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, Madrid, Spain"},{"name":"3Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Cardiovasculares (CIBERCV)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina Candida","family":"Quarta","sequence":"additional","affiliation":[{"name":"4Institute of Cardiology, University of Bologna and S Orsola-Malpighi Hospital, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. Javier","family":"de Haro-del Moral","sequence":"additional","affiliation":[{"name":"5Department of Nuclear Medicine, Hospital Universitario Puerta de Hierro, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnese","family":"Milandri","sequence":"additional","affiliation":[{"name":"4Institute of Cardiology, University of Bologna and S Orsola-Malpighi Hospital, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Salas","sequence":"additional","affiliation":[{"name":"3Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Cardiovasculares (CIBERCV)"},{"name":"6Department of Pathology, Hospital Universitario Puerta de Hierro, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Cinelli","sequence":"additional","affiliation":[{"name":"4Institute of Cardiology, University of Bologna and S Orsola-Malpighi Hospital, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Cobo-Marcos","sequence":"additional","affiliation":[{"name":"1Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, Madrid, Spain"},{"name":"3Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Cardiovasculares (CIBERCV)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Lorenzini","sequence":"additional","affiliation":[{"name":"4Institute of Cardiology, University of Bologna and S Orsola-Malpighi Hospital, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Lara-Pezzi","sequence":"additional","affiliation":[{"name":"2Myocardial Biology Programme, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain"},{"name":"3Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Cardiovasculares (CIBERCV)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Foffi","sequence":"additional","affiliation":[{"name":"4Institute of Cardiology, University of Bologna and S Orsola-Malpighi Hospital, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Alonso-Pulpon","sequence":"additional","affiliation":[{"name":"1Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, Madrid, Spain"},{"name":"3Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Cardiovasculares (CIBERCV)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Rapezzi","sequence":"additional","affiliation":[{"name":"4Institute of Cardiology, University of Bologna and S Orsola-Malpighi Hospital, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Garcia-Pavia","sequence":"additional","affiliation":[{"name":"1Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, Madrid, Spain"},{"name":"3Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Cardiovasculares (CIBERCV)"},{"name":"7Medical School, Francisco de Vitoria University, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,3,1]]},"reference":[{"key":"2022102517425435500_ehx043-B1","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1080\/07853890701842988","article-title":"Senile systemic amyloidosis affects 25% of the very aged and associates with genetic variation in alpha2-macroglobulin and tau: a population-based autopsy study","volume":"40","author":"Tanskanen","year":"2008","journal-title":"Ann Med"},{"key":"2022102517425435500_ehx043-B2","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/S0025-6196(12)64885-X","article-title":"Pathology of the senescent heart: anatomic observations on 237 autopsy studies of patients 90 to 105 years old","volume":"63","author":"Lie","year":"1988","journal-title":"Mayo Clin Proc"},{"key":"2022102517425435500_ehx043-B3","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.recesp.2011.05.003","article-title":"Amyloidosis. 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