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Researchers have not extensively studied cardiac amyloidosis expressions, phenotype, and all-cause mortality differences between men and women.

Women may show different cardiac amyloidosis expressions due to genetic and physical factors, such as a smaller heart size. There is especially concern about the risk of mortality attributed to transthyretin amyloid cardiomyopathy (ATTR-CM). Evaluating these differences may help clinicians tailor their process for diagnosis and treatment.

A retrospective study published in the International Journal of Cardiology investigated how gender affects cardiac amyloidosis expressions, cardiac phenotype, and all-cause mortality. The researchers analyzed the data of Careggi University Hospitalโ€™s patients diagnosed with cardiac amyloidosis between 2000 and 2020. 259 patients (12% females) were diagnosed with wild-type transthyretin amyloidosis (wtATTR), 52 (25% females) with hereditary transthyretin amyloidosis (hATTR), and 143 (47% females) with light chain (AL) amyloidosis.

Researchers did not find statistically significant differences between women and men regarding all-cause mortality due to wtATTR, hATTR, and AL amyloidosis. However, women with wtATTR were significantly older than men at the time of diagnosis and showed a more advanced prognosis, possibly signifying later recognition of the disease than men. Women with wtATTR showed higher National Amyloidosis Centre score, thicker intraventricular septum, higher diastolic dysfunction, and poorer right ventricular function. Females with hATTR or AL amyloidosis had a lower cardiac mass than men. However, there were no gender differences regarding bio-humoral parameters, New York Heart Association classification, and electrocardiogramย characteristics.

While there may not be a statistically significant difference in all-cause mortality between men and women with cardiac amyloidosis, clinical expression differences are essential to consider. Nevertheless, females may show signs of more advanced diseases than males. By being aware of these differences, healthcare providers can diagnose patients sooner.

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Source:

Zampieri, M., Argirรฒ, A., Allinovi, M., Tassetti, L., Zocchi, C., Gabriele, M., Andrei, V., Fumagalli, C., Di Mario, C., Tomberli, A., Olivotto, I., Perfetto, F., & Cappelli, F. (2022). Sex-related differences in clinical presentation and all-cause mortality in patients with cardiac transthyretin amyloidosis and light chain amyloidosis. International Journal of Cardiology, 351, 71-77. https://doi.org/10.1016/j.ijcard.2021.12.048ย