JACC. Case reports · 2026
Long-Term Hemodynamic Stabilization With TTR-Stabilizing Therapy and Pressure-Guided Management in ATTR Cardiomyopathy.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Sedighi Jamschid, Unsöld Bernhard, Boettger Priyanka, Herrmann Ester J, Dörr Oliver, Hassan Hassan, Drewenka Anne, Sossalla Samuel T, Assmus Birgit
Аннотация
BACKGROUND: Transthyretin amyloidosis with cardiomyopathy (ATTR-CM) is underdiagnosed in heart failure with preserved ejection fraction. Although disease-modifying therapies slow the disease progression, their long-term hemodynamic effects remain unclear.
CASE SUMMARY: An 82-year-old woman with recently confirmed wild-type ATTR-CM and NYHA functional class III heart failure with preserved ejection fraction underwent pulmonary artery pressure (PAP) sensor implantation for recurrent heart failure hospitalizations shortly after the initiation of transthyretin-stabilizing therapy in 2022. During 3.5 years of follow-up, diastolic PAP decreased from 21 to 7 mm Hg, accompanied by torasemide reduction from 60 to 10 mg/day.
DISCUSSION: In this case, the combination of transthyretin-stabilizing therapy and PAP-guided follow-up was associated with sustained hemodynamic improvement and clinical stability. However, the independent contribution of pulmonary artery monitoring cannot be determined from a single uncontrolled observation.
TAKE-HOME MESSAGE: Remote PAP-guided management may support disease-modifying treatment in selected patients with ATTR-CM.
CASE SUMMARY: An 82-year-old woman with recently confirmed wild-type ATTR-CM and NYHA functional class III heart failure with preserved ejection fraction underwent pulmonary artery pressure (PAP) sensor implantation for recurrent heart failure hospitalizations shortly after the initiation of transthyretin-stabilizing therapy in 2022. During 3.5 years of follow-up, diastolic PAP decreased from 21 to 7 mm Hg, accompanied by torasemide reduction from 60 to 10 mg/day.
DISCUSSION: In this case, the combination of transthyretin-stabilizing therapy and PAP-guided follow-up was associated with sustained hemodynamic improvement and clinical stability. However, the independent contribution of pulmonary artery monitoring cannot be determined from a single uncontrolled observation.
TAKE-HOME MESSAGE: Remote PAP-guided management may support disease-modifying treatment in selected patients with ATTR-CM.