Amyloid deposits in prostate biopsy as an opportunity to diagnose early cardiac amyloidosis
María Cespón-Fernández1
Edgar José Escalona-Canal2
Jorge Sánchez-Ramos3
Sergio Raposeiras-Roubín1
Sámer Abdulkader-Sande4
Rafael José Cobas-Paz1
Cristina Torre-ira-Banzas5
Emad Abu-Assi1
Susana Teijeira-Bautista6
Patricia Domínguez-Aristegui6
Pablo García-Pavía7
María Eugenia Escalona-Canal8
Enrique Cespón-Outeda3
José Ant-onio Ortiz-Rey9
1.Cardiology Department,Hospital Universitario Álvaro Cunqueiro,Vigo,Spain;Galicia Sur Health Research Insti-tute,Spain2.Emergency Department,Hospital Universitario de Pontevedra,Spain;University of Santiago de Compostela,Spain3.Urology Department,Hospital Universitario Álvaro Cunqueiro,Vigo,Spain4.Pathology Department,Hospital Universitario Álvaro Cunqueiro,Vigo,Spain5.Laboratory Department,Hospital Universitario Álvaro Cunqueiro,Vigo,Spain6.Galicia Sur Health Research Insti-tute,Spain;Biobank of Galicia Sur Health Research Institute(IIS Galicia Sur).SERGAS-UVIGO,Vigo,Spain7.Cardiology Department,Heart Failure and Inherited Cardiac Dis-eases Unit,Hospital Universitario Puerta de Hierro Majadahonda,Madrid,Spain8.Pathology Department,Hospital Universitario de A Coruña,A Coruña,Spain9.Galicia Sur Health Research Insti-tute,Spain;Pathology Department,Hospital Universitario Álvaro Cunqueiro,Vigo,Spain
摘要：Background The diagnostic delay of cardiac amyloidosis(CA)is known to be substantially long.A prolonged time from symp-toms onset to diagnosis negatively impacts quality of life and life expectancy of the affected patients.We aim to describe the role of the incidental finding of amyloid deposits in prostatic tissue as an early marker of CA.
Methods A systematic cardiological evaluation,comprising ECG,echocardiogram and 99mTc-DPD scintigraphy,was offered to a cohort of 19 patients with incidental prostatic amyloidosis(PA)findings,propectively detected between 2014-2023,to assess cardiac involvement.
Results The median age of the patients was 80.2 years(IQR:74.9-82.6 years).Histopathological study revealed amyloid depo-sits within the walls of small vessels(predominantly small arteries)in 18 patients and mainly in the stroma in the remaining case.All of them were immunohistochemically positive for transthyretin(ATTR)except one patient,with known myeloma,which was unconclusive fo ATTR.Clonal dyscrasia was excluded in the rest of the patients.Thirteen patients(68.4％)underwent all cardiolo-gical tests,4 patients(21.1％)underwent only ECG and echocardiographic evaluation and two patients(10.5％)refused to under-go any cardiological study.Among 13 individuals undergoing the complete evaluation,six patients were eventually diagnosed with CA(46.15％).All of them were asymptomatic from a cardiovascular point of view at the time of the prostate biopsy.
Conclusion The finding of PA should prompt a complete cardiovascular examination,given the significant percentage of pa-tients eventually diagnosed with early-stage CA.Multidisciplinary collaboration among different medical specialists must be en-couraged,given the potential clinical impact of CA early diagnosis.
机标关键词：prostatebiopsyamyloidosiscardiacdepositsdiagnoseearlyopportunity
论文发表日期：2025-01-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 169-177 )