Table 1. Classification of amyloidosis with cardiac involvement.
Main disorders | Amyloidogenic proteins | Main organ involvement | Extra-cardiac presentations | Outcomes and management | |
AL | Plasma cell dyscrasia | Light chain (Plasma cell dyscrasia) | Heart (~70%), kidney (~70%), liver (~40%), nerve (~20%) | Fatigue, ecchymosis, shoulder pad pain, Macroglossia, diarrhea | Chemotherapy, ASCT |
ATTRv | Inherited ATTR gene mutation | Transthyretin | Nerve (major, ~70%), heart (30~100%), kidney (~20%) | Autonomic dysfunction, Spinal stenosis, CTS | TTR stabilizer, oligonucleotide therapy, liver transplantation |
ATTRwt | Aging | Transthyretin | Heart (100%), kidney (~20%), nerve (~20%) | Spinal stenosis, CTS, Biceps tendon rupture | TTR stabilizer |
AA | Systemic or inflammatory diseases | Serum amyloid A | Kidney (major, ~70%), heart (~5%), liver (~20%) | Nephropathy, hepatomegaly | Control of inflammatory disease |
Aβ2M | Hemodialysis | β2-microglobulin | Heart (~80%), nerve (~16%), | CTS | No specific therapy |
HGA | AD inherited form | Gelsolin | Nerve (~70%), eyes (~80%), skin (~80%), heart (~5%) | Cranial and peripheral neuropathy, corneal lattice dystrophy, cutis laxa (loose skin) | No specific therapy (similar life scan) |
AA, serum amyloid A amyloidosis; AD, autosomal dominant; AL, amyloid light-chain; ASCT, autologous stem cell transplant; ATTRv, hereditary transthyretin amyloidosis; ATTRwt, wild-type transthyretin amyloidosis; Aβ2M, β2-microglobulin; CTS, carpal tunnel syndrome; HGA, hereditary gelsolin amyloidosis; TTR, transthyretin.