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Heart Failure Reviews
Published in: Heart Failure Reviews 2/2024

Open Access 11-08-2023 | Cardiac Amyloidosis

Sex differences in transthyretin cardiac amyloidosis

Authors: Alberto Aimo, Giorgia Panichella, Manuel Garofalo, Simone Gasparini, Chiara Arzilli, Vincenzo Castiglione, Giuseppe Vergaro, Michele Emdin, Silvia Maffei

Published in: Heart Failure Reviews | Issue 2/2024

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Abstract

Transthyretin cardiac amyloidosis (ATTR-CA) is a progressive disease characterized by the deposition of abnormal transthyretin protein fibrils in the heart, leading to cardiac dysfunction. Recent evidence suggests that sex differences may play a significant role in various steps of ATTR-CA, including clinical presentation, diagnostic challenges, disease progression, and treatment outcomes. ATTR-CA predominantly affects men, whereas women are older at presentation. Women generally present with a history of heart failure with preserved ejection fraction and/or carpal tunnel syndrome. When indexed, left ventricular (LV) wall thickness is equal, or even increased, than men. Women also have smaller LV cavities, more preserved ejection fractions, and apparently a slightly worse right ventricular and diastolic function. Given the under-representation on women in clinical trials, no data regarding sex influence on the treatment response are currently available. Finally, it seems there are no differences in overall prognosis, even if premenopausal women may have a certain level of myocardial protection. Genetic variations, environmental factors, and hormonal changes are considered as potential contributors to observed disparities. Understanding sex differences in ATTR-CA is vital for accurate diagnosis and management. By considering these differences, clinicians can improve diagnostic accuracy, tailor treatments, and optimize outcomes for both sexes with ATTR-CA.
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Metadata
Title
Sex differences in transthyretin cardiac amyloidosis
Authors
Alberto Aimo
Giorgia Panichella
Manuel Garofalo
Simone Gasparini
Chiara Arzilli
Vincenzo Castiglione
Giuseppe Vergaro
Michele Emdin
Silvia Maffei
Publication date
11-08-2023
Publisher
Springer US
Published in
Heart Failure Reviews / Issue 2/2024
Print ISSN: 1382-4147
Electronic ISSN: 1573-7322
DOI
https://doi.org/10.1007/s10741-023-10339-w

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