摘要

The prevalence of calcific aortic stenosis (AS) and of cardiac amyloidosis (CA) increases with age, and their association is not uncommon in the elderly. The identification of CA is particularly challenging in patients with AS because these 2 conditions share several features. It is estimated that ≤15% of the AS population and ≤30% of the subset with low-flow, low-gradient pattern may have CA. In patients with AS, CA is associated with increased risk of heart failure, mortality, and treatment futility with aortic valve replacement. In case of suspicion of CA, it is thus crucial to confirm the diagnosis to guide therapeutic management of AS and eventually implement recently developed pharmacological treatment dedicated to transthyretin amyloidosis. Given the high surgical risk of patients with AS and concomitant CA, transcatheter aortic valve replacement may be preferred to surgery in these patients.

译文

钙化性主动脉瓣狭窄 (AS) 和心脏淀粉样变 (CA) 的患病率随着年龄的增长而增加，它们的相关性在老年人中并不少见。在 AS 患者中识别 CA 尤其具有挑战性，因为这两种情况具有几个共同特征。据估计，≤ 15% 的 AS 总体和 ≤ 30% 的具有低流量、低梯度模式的子集可能具有 CA。在 AS 患者中，CA 与心脏衰竭、死亡率和主动脉瓣置换治疗无效的风险增加有关。因此，在怀疑 CA 的情况下，确认诊断以指导 AS 的治疗管理是至关重要的，并最终实施最近开发的专门用于转甲状腺素淀粉样变的药物治疗。鉴于患有 AS 和伴随 CA 的患者手术风险高，在这些患者中，经导管主动脉瓣置换可能比手术更受欢迎。