What is ATTR-CM?
ATTR – Cardiac amyloidosis is a disease of the heart muscle. It is caused by the buildup of abnormal proteins (amyloid) in the heart walls.
ATTR-CM reduces the heart’s ability to pump blood properly. This can lead to heart failure.
There are two types of ATTR-CM:
- Wild type ATTR-CM
- caused by natural aging
- May affect the heart and nervous system
- More common in men
While most people diagnosed are men, ATTR-CM is underdiagnosed in women.
- Hereditary ATTR-CM
- It is run by families.
- It is caused by changes in genes.
- May affect the heart, nervous system, kidneys, and other organs
- Risk factors include:
- Family history of heart disease or ATTR-CM
- old age
- Black or Afro-Caribbean
About 1 in 25 black Americans carry the V122I gene, which increases the risk of hereditary ATTR-CM.
ATTR-CM Symptoms
Especially in the case of wild-type ATTR-CM, there may be no or mild symptoms at first.
Symptoms may reflect other conditions, such as menopause, or may appear unrelated to heart disease.
People with ATTR-CM may experience:
- shortness of breath
- my legs are swollen
- Gastrointestinal problems, such as stomach bloating
- Irregular or fast heartbeat
- fatigue
If left untreated, ATTR-CM can lead to hospital visits, complex heart problems, and a shortened lifespan.
Nerves may also be affected. Protein buildup in the nervous system can cause complications, including:
- carpal tunnel syndrome
- Numbness or tingling in your hands and feet
- nerve pain
- Spinal stenosis (back pain caused by spinal stenosis)
How is ATTR-CM diagnosed?
Along with your symptoms, your healthcare provider may use diagnostic imaging to determine if further testing is needed.
Genetic testing can then be done to determine whether the condition is hereditary.
ATTR-CM likely affects more than 400,000 patients worldwide. However, many people, especially women, remain undiagnosed.
What causes ATTR-CM?
A protein called transthyretin (TTR) is made in the liver and performs many important functions, including transport:
- Thyroid hormones (necessary to regulate metabolism for health and well-being)
- Vitamin A (for vision health)
ATTR-CM occurs when TTR becomes unstable, breaks, and misfolds.
How is ATTR-CM treated?
ATTR-CM is not curable, but treatment can help prevent the disease from getting worse and relieve symptoms.
Types of treatment include:
- TTR knockdown
- The amount of TTR in your body may decrease.
- TTR stabilizer
- It may increase the amount of TTR in your body.
Measuring TTR levels can give your healthcare provider an idea of how effective your treatment is.
Lifestyle changes are important when living with ATTR-CM.
- Eat a Heart-Healthy Diet
- Monitor your sodium intake
- If possible, walk and exercise every day.
- alcohol restrictions
Wondering if you have ATTR-CM or are at risk?
Talk to your health care provider about treatment options so that together you can decide what is best for you. Early diagnosis and treatment may help slow the progression of ATTR-CM and lead to better health outcomes.
This training material was created in partnership with BlackDoctor and with support from BridgeBio.
