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Impact of Genetic Testing in Transthyretin (ATTR) Cardiac Amyloidosis

  • Deepa M. GopalEmail author
  • Frederick L. Ruberg
  • Omar K. Siddiqi
Biomarkers of Heart Failure (J. Grodin & W.H.W. Tang, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Biomarkers of Heart Failure

Abstract

Purpose of Review

The review’s main focus centers on the genetics of hereditary cardiac amyloidosis, highlighting the opportunities and challenges posed by the widespread availability of genetic screening and diagnostic cardiac imaging.

Recent Findings

Advancements in cardiac imaging, heightened awareness of the ATTR amyloidosis diagnosis, and greater access to genetic testing have all led to an increased appreciation of the prevalence of ATTR cardiac amyloidosis. Elucidation of the TTR molecular structure and effect of mutations on TTR function have allowed for novel TTR therapy development leading to clinical implementation of transthyretin stabilizers and transthyretin gene silencers.

Summary

The transthyretin amyloidoses are a diverse group of protein misfolding disorders with cardiac and peripheral/autonomic nervous system manifestations due to protein deposition. Genetic screening allows for the early identification of asymptomatic TTR mutation carriers. With the advent of TTR-specific therapeutics, clinical guidance is necessary for the management of individuals with mutations in the TTR gene without evidence of disease.

Keywords

Cardiac amyloidosis Transthyretin Hereditary amyloidosis Cardiomyopathy Genetic cardiomyopathy 

Notes

Funding Information

Dr. Gopal is supported by a career development grant from the American Heart Association (FTF 17FTF33670369). Dr. Ruberg is supported by the National Institutes of Health (R01 HL139671).

Compliance with Ethical Standards

Conflict of Interest

Dr. Ruberg and Dr. Gopal receive research funding from Eidos Therapeutics. Dr. Ruberg receives research and consulting income from Pfizer. Dr. Siddiqi has no conflicts to disclose.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Deepa M. Gopal
    • 1
    • 2
    Email author
  • Frederick L. Ruberg
    • 1
    • 2
    • 3
  • Omar K. Siddiqi
    • 1
    • 2
  1. 1.Amyloidosis Center Boston University School of Medicine, Boston Medical CenterBostonUSA
  2. 2.Section of Cardiovascular MedicineBoston University School of Medicine, Boston Medical CenterBostonUSA
  3. 3.Department of RadiologyBoston University School of Medicine, Boston Medical CenterBostonUSA

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