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The prevalence of transthyretin amyloid cardiomyopathy (ATTR-CM) is reportedly lower in women than men. As a life-threatening heart condition, ATTR-CM can often lead to heart failure and other complications, including death. However, sex-related differences have not been assessed in detail.ย 

This systematic review, published inย Heart Failure Reviews, sought to determine whether there are differences in the clinical presentation and epidemiology of ATTR-CM between men and women. Cochrane, Embase, and MEDLINE databases were searched to gather clinical and observational studies that presented sex-specific data. The studies included in the literature review included sex-specific data for both hereditary and wild-type ATTR-CM. In total, 69 studies were included in a pooled analysis.ย ย 

Of the 4,669 patients with ATTR-CM analyzed in studies that included hereditary, wild-type, or undefined ATTR-CM, around 800 were women. The available data on the presentation of the disease were limited and heterogeneous. However, some trends suggested sex-specific differences between men and women with ATTR-CM.

For example, women were found to have lower interventricular septal and posterior wall thickness and left ventricular (LV) end-diastolic diameter. Women were also found to have higher LV ejection fractions than men across all subtypes of ATTR-CM.

Data from this study suggest that women may be underdiagnosed with ATTR-CM. A left ventricular wall thickness of over 12 millimeters is usually the threshold for diagnosing ATTR-CM in both men and women. However, due to smaller cardiac anatomy, female characteristics may not be accounted for in diagnostic factors for ATTR-CM.

Therefore, healthcare providers should be aware of potential sex-specific differences that could affect the clinical presentation of ATTR-CM. More research is also needed to further explore these differencesย [1].

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Source:

[1] Bruno, M., Castaรฑo, A., Burton, A., & Grodin, J. L. (2020). Transthyretin amyloid cardiomyopathy in women: frequency, characteristics, and diagnostic challenges.ย Heart Failure Reviews,ย 26(1), 35โ€“45. https://doi.org/10.1007/s10741-020-10010-8