Wild-Type Transthyretin Amyloidosis in Female Patients　― Consideration of Sex Differences ―

• Ochi Yuri

  Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University

• Kubo Toru

  Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University

• Baba Yuichi

  Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University

• Sugiura Kenta

  Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University

• Ueda Motoko

  Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University

• Miyagawa Kazuya

  Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University

• Noguchi Tatsuya

  Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University

• Hirota Takayoshi

  Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University

• Hamada Tomoyuki

  Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University

• Yamasaki Naohito

  Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University

• Kitaoka Hiroaki

  Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University

Abstract

Background:With recent advances in non-invasive diagnostic tools, some studies indicate that wild-type transthyretin amyloidosis (ATTRwt) may be more common in females than previously reported. However, the clinical characteristics of female ATTRwt patients have not been determined. Methods and Results:Of the 78 consecutive patients with ATTRwt in our cohort, 14 (17.9 %) were female. Compared with male patients, female ATTRwt patients had smaller left ventricular (LV) wall thicknesses (ventricular septum thickness 12.9 vs. 14.2 mm [P=0.081]; posterior wall thickness 12.7 vs. 13.6 mm [P=0.035]) and a higher LV ejection fraction (EF; mean [±SD] 58.4±8.9% vs. 48.9±11.8%; P=0.006). However, the severity of heart failure (HF), as assessed by HF stage, New York Heart Association functional class and B-type natriuretic peptide concentrations, did not differ between female and male patients. Moreover, LV mass index and relative wall thickness were increased and the stroke volume index was reduced in both female and male patients. In organ biopsies, female patients had a higher sensitivity to transthyretin deposition from abdominal fat than male patients (positive abdominal fat biopsy 80.0 % vs. 26.5%; P=0.016). Conclusions:This study suggests that a relatively large proportion of elderly females have ATTRwt. Female ATTRwt patients had HF symptoms even at the stage of mild LV hypertrophy and preserved EF. Abdominal fat biopsy may be useful to diagnose ATTRwt, especially in female patients with HF.

Journal

• Circulation Reports

  Circulation Reports 3 (8), 465-471, 2021-08-10

  The Japanese Circulation Society

Keywords

• Cardiac amyloidosis
• Female patient
• Sex differences
• Wild-type transthyretin amyloidosis

Details

• CRID: 1390570465069101952
• NII Article ID: 130008072742
• DOI: 10.1253/circrep.cr-21-0067
• ISSN: 24340790
• Web Site: https://www.jstage.jst.go.jp/article/circrep/3/8/3_CR-21-0067/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2022174162
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed