kpcczКомплексные проблемы сердечно-сосудистых заболеванийComplex Issues of Cardiovascular Diseases2306-12782587-9537Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”10.17802/2306-1278-2024-13-3-92-104kpccz-1370Research ArticleОНЛАЙН. АНАЛИТИЧЕСКИЙ ОБЗОР. Кардиология. Внутренние болезниREVIEW. Cardiology. Internal medicineТРАНСТИРЕТИНОВАЯ (ATTR) АМИЛОИДНАЯ КАРДИОМИОПАТИЯ В НАШИ ДНИ. РАСПРОСТРАНЕННОЕ ЗАБОЛЕВАНИЕ С ОТКРЫТЫМИ ПРОБЛЕМАМИTRANSTIRETINIC (ATTR) AMYLOID CARDIOMYOPATHY NOWADAYS. A COMMON DISEASE WITH OPEN PROBLEMShttps://orcid.org/0000-0002-3922-009XГолубовскаяДарья ПетровнаGolubovskayaDarya P.

младший научный сотрудник лаборатории фиброгенеза миокарда федерального государственного бюджетного научного учреждения «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний», Кемерово, Российская Федерация

Junior Researcher at the Laboratory of Myocardial Fibrogenesis, Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”, Kemerovo, Russian Federation

dasha250695k@mail.ruhttps://orcid.org/0000-0002-4771-484XПечеринаТамара БорзалиевнаPecherinaTamara B.

доктор медицинских наук, доцент заведующая лабораторией фиброгенеза миокарда федерального государственного бюджетного научного учреждения «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний», Кемерово, Российская Федерация

PhD, Associate Professor, Head of the Laboratory of Myocardial Fibrogenesis, Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”, Kemerovo, Russian Federation

tb.pechorina@gmail.comhttps://orcid.org/0000-0002-4642-3610БарбарашОльга ЛеонидовнаBarbarashOlga L.

академик РАН, доктор медицинских наук, профессор директор федерального государственного бюджетного научного учреждения «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний», Кемерово, Российская Федерация

Member of the Russian Academy of Sciences, Professor, PhD, Head of the Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”, Kemerovo, Russian Federation

olb61@mail.ruФедеральное государственное бюджетное научное учреждение «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний»РоссияFederal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”Russian Federation20243009202413392104Copyright © Голубовская Д.П., Печерина Т.Б., Барбараш О.Л., 20242024Голубовская Д.П., Печерина Т.Б., Барбараш О.Л.Golubovskaya D.P., Pecherina T.B., Barbarash O.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nii-kpssz.com/jour/article/view/1370Основные положения

Основные положения

Представлен обзор актуальных литературных данных, которые посвящены последним изменениям в эпидемиологии и особенностям транстиретинового амилоидоза. В обзоре освещены факторы, повышающие вероятность наличия у пациента данного заболевания, акцентировано внимание на группе больных высокого риска, а также представлены проблемы неинвазивного диагностического ведения лиц с амилоидозом сердца в клинической практике.

 

 

Резюме

Резюме

Транстиретиновая (ATTR) амилоидная кардиомиопатия – тяжелое инфильтративное заболевание сердца с формированием сердечной недостаточности (СН), как правило, с сохранной и умеренно сниженной фракцией выброса левого желудочка, с рестриктивным и ложногипертрофическим фенотипом, негативно влияющее на прогноз и качество жизни пациентов. В отсутствие своевременной специфической терапии медиана выживаемости приближена к 2–3,5 годам для разных форм ATTR-амилоидоза. Достижения в области неинвазивной визуализации сердца, доступность генетического тестирования,выделение групп пациентов высокого риска амилоидной кардиомиопатии, появление новых методов специфического лечения хоть и привели к увеличению выявляемости заболевания, однако уже на ее поздних стадиях (когда представлены развернутая картина СН и выраженное утолщение стенок сердца), что отрицательно сказывается на прогнозе больных. Междисциплинарный подход, настороженность и своевременная диагностика имеют решающее значение как для ATTR-амилоидоза, так и для проблемы СН в целом.

Highlights

Highlights

The article presents a review of literature data devoted to the latest changes in the epidemiology and features of transthyretin (ATTR) amyloidosis. The review highlights factors that increase the likelihood of a patient having this disease, emphasizing the group of high-risk patients, and discusses issues of non-invasive diagnostic management of a patient with cardiac amyloidosis in clinical practice.

 

 

Abstract

Abstract

Transthyretin (ATTR) amyloid cardiomyopathy is a severe infiltrative heart disease that followed by heart failure (HF) with a preserved and moderately reduced left ventricular ejection fraction and a restrictive phenotype. It negatively affects the prognosis and quality of life of patients. In the absence of timely treatment, the median survival is 2–3.5 years for different forms of ATTR amyloidosis. Advances in noninvasive cardiac imaging, availability of genetic testing, identification of «high risk» groups of patients with amyloid cardiomyopathy, and the emergence of new methods of treatment have increased the detection rate of the disease, but only at its later stages (when a patient suffers from heart failure and pronounced hypertrophic cardiomyopathy), which negatively affects the prognosis of patients. Therefore, an interdisciplinary approach, vigilance, and timely diagnostics are crucial for both ATTR amyloidosis and the problem of heart failure in general.

Транстиретиновая амилоидная кардиомиопатияАмилоидозСердечная недостаточность с сохранной фракцией выбросаСцинтиграфияTransthyretin amyloid cardiomyopathyAmyloidosisHeart failure with preserved ejection fractionScintigraphyАвторы заявляют об отсутствии финансирования исследования.ReferencesHassan W., Al-Sergani H., Mourad W., Tabbaa R. Amyloid heart disease. New frontiers and insights in pathophysiology, diagnosis, and management. Tex Heart Inst J. 2005;32(2):178-84.Hassan W., Al-Sergani H., Mourad W., Tabbaa R. Amyloid heart disease. New frontiers and insights in pathophysiology, diagnosis, and management. Tex Heart Inst J. 2005;32(2):178-84.Benson M.D., Buxbaum J.N., Eisenberg D.S., Merlini G., Saraiva M.J.M., Sekijima Y., Sipe J.D., Westermark P. Amyloid nomenclature 2018: recommendations by the International Society of Amyloidosis (ISA) nomenclature committee. 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The authors declare that there are no conflicts of interest present.