‘Masked apical sparing’ in wild-type transthyretin cardiac amyloidosis complicated by aortic valve stenosis: a case report

This case indicates the potential benefit of combining tafamidis therapy with TAVI in patients with ATTRwt-CA and AS. Serial assessment of global longitudinal strain (GLS) provides valuable insights into myocardial function beyond the ejection fraction. The absence of the apical sparing sign prior to TAVI and the improvement of apical LS following the interventional afterloading suggest the risk of overlooking the characteristic GLS features of ATTRwt-CA when complicated with AS.