TRANSTIRETINIC (ATTR) AMYLOID CARDIOMYOPATHY NOWADAYS. A COMMON DISEASE WITH OPEN PROBLEMS

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 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.