Cardiac Amyloidosis: A Survey of Current Awareness, Diagnostic Modalities, Treatment Practices, and Clinical Challenges Among Cardiologists in Selected Middle Eastern Countries

Abstract

Introduction: Cardiac amyloidosis is a chronic and progressive disease caused by the deposition of amyloid fibrils in cardiac tissues. The diagnosis and management of cardiac amyloidosis are complicated and have developed over the years. Methods: An online survey was sent to cardiologists in four countries (Saudi Arabia, Lebanon, Egypt, and Iraq) interested in heart failure and had been practicing for more than a year. The survey included questions about the characteristics of the participants and their affiliated institutes. The survey addresses their knowledge and practices in cardiac amyloidosis concerning diagnostic modalities, treatment options, and interest in education and knowledge exchange. Results: A total of 85 physicians participated in the online survey. Twenty-five were from Saudi Arabia, 24 from Lebanon, 24 from Egypt, and 12 from Iraq. There was a variation in the participating cardiologists’ knowledge, experience level, and readiness of their affiliated institutes to manage patients with ATTR-CM. Most participants believed that high rate of ATTR-CM misdiagnosis existed. Participants’ knowledge varied concerning the diagnostic modalities and ‘red flags’ raising suspicion about ATTR-CM. Another challenge was the availability of essential diagnostic modalities among various cardiology centers. A knowledge gap was also present regarding the updates in ATTR-CM management. However, there was a high endorsement towards the need for more education, physician networking, and knowledge exchange. Discussion and Conclusion: This survey highlighted the need for increasing awareness levels among cardiologists in the four selected Arab countries. Cardiologists are most likely to benefit from additional training and knowledge exchange on the latest management advances of this disease. Thus, measures must be taken to focus on the physician’s awareness of ATTR-CM patient journey to achieve a better quality of care and outcome.