Abstract
Cardiac amyloidosis (CA) is a restrictive cardiomyopathy characterized by deposition of amyloid in the myocardium and recent studies revealed it is more frequently seen than we thought. Advances in diagnosis and treatment have been made over the last few years that make it desirable to diagnose CA without delay, and that may require extra education. An online survey was conducted among cardiologists from Romania, representing the first assessment of the knowledge of CA among them, with 195 cardiologists answering the questionnaire. There was a wide variation in their knowledge regarding CA. Our participants had limited experience with CA and reported a significant delay between first cardiac symptoms and diagnosis. We address the gaps in knowledge that were identified as educational opportunities in the main identified areas: prevalence and treatment of wild type transthyretin amyloidosis (ATTRwt), prevalence of variant transthyretin amyloidosis (ATTRv) in Romania, diagnosis of CA, the delay in CA diagnosis and available treatment options. Awareness among cardiologists is the most important challenge in diagnosing CA. Romanian cardiologists are partially aware of this topic, but there are still gaps in their knowledge. Educational programs can improve screening of patients with a high suspicion for this progressive condition the prognosis of which has been dramatically changed by the new treatment options.
Highlights
Cardiac amyloidosis (CA) is a restrictive cardiomyopathy characterized by deposition of amyloid which is represented by misfolded proteins in the myocardial interstitium [1]
We performed a survey of the practicing cardiologists from Romania in order to assess their awareness regarding the epidemiology, diagnosis and available treatment options of cardiac amyloidosis, and how this reflects in their practice
In the event of treating patients with suspected CA, 92% of the participants responded they would refer these patients to an expert center, only 22% stated they would initiate the specific treatment and a further 7% said they would continue the heart failure (HF) treatment and would not refer these patients as they did not see the need for further investigations because there is no specific treatment for patients with CA
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. In a study involving 1034 patients with CA from the UK National Amyloidosis Centre with a subset of 534 patients in whom complete data on hospital service usage were available, there was a median diagnostic delay from the first presentation with cardiac symptoms of 39 (8–78) months in patients with ATTRwt, with 42% waiting more than 4 years for the diagnosis to be established and a median delay of 25 (4–60) months in the ATTRv group [15]. We performed a survey of the practicing cardiologists from Romania in order to assess their awareness regarding the epidemiology, diagnosis and available treatment options of cardiac amyloidosis, and how this reflects in their practice
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