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Impact of the Non-Invasive Diagnostic Algorithm on ...
Article: Impact of the Non-Invasive Diagnostic Alg ...
Article: Impact of the Non-Invasive Diagnostic Algorithm on Clinical Presentation and Prognosis in Cardiac Amyloidosis
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The study analyzes the impact of a noninvasive diagnostic algorithm, introduced in 2016 by Gillmore and colleagues, on the diagnosis and prognosis of cardiac amyloidosis (CA) in Italy. The research, conducted across five major Italian Cardiomyopathy Referral Centers, involved 887 patients diagnosed with different subtypes of CA: light-chain (AL), variant transthyretin-related (ATTRv), and wild-type transthyretin-related (ATTRwt).<br /><br />Findings from this study indicate that the adoption of this algorithm marked a significant turning point in CA diagnosis and management. Specifically, the number of CA diagnoses notably increased after 2016, particularly for ATTRwt. Patients diagnosed post-2016 were generally older but exhibited less severe symptoms and cardiac manifestations at diagnosis, compared to those diagnosed earlier. This shift is attributed to improved diagnostic capabilities, which allowed earlier detection of the disease, sometimes at an incidental stage, and reflects an increased awareness and sensibility towards CA among healthcare providers.<br /><br />In terms of outcomes, the study observed that patients diagnosed after the introduction of the noninvasive diagnostic algorithm had a markedly better prognosis, particularly evident within the first year of diagnosis. The study highlighted that the interaction between year of diagnosis and CA subtype was significant, with the diagnosis post-2016 being more favorably associated with outcomes in TTR-related CA than in AL.<br /><br />The study concludes that the noninvasive diagnostic algorithm not only facilitated an increased number of diagnoses but also contributed to identifying CA at less severe stages, thereby improving short-term outcomes. Despite these advances, there's still a considerable portion of patients diagnosed at an advanced stage, highlighting the need for continued efforts in early CA diagnosis and management.
Keywords
cardiac amyloidosis
noninvasive diagnostic algorithm
Italy
Gillmore
ATTRwt
AL
ATTRv
prognosis
early detection
healthcare awareness
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