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The following is a summary of “Circulating ECM proteins decorin and alpha-L-iduronidase differentiate ATTRwt-CM from ATTRwt-negative HFpEF/HFmrEF,” published in the September 2024 issue of Cardiology by Tubben et al.
Wild-type transthyretin cardiac amyloidosis (ATTRwt-CM) is an under-recognized cause of heart failure (HF), requiring early identification for treatment.
Researchers conducted a retrospective study using circulating biomarkers to differentiate ATTRwt-CM from patients with ATTRwt-negative heart failure with preserved ejection fraction (HFpEF) or heart failure with mid-range ejection fraction (HFmrEF).
They measured serum concentrations of 363 protein biomarkers in a discovery cohort of 73 patients with ATTRwt-CM, 55 AL-CM, and 59 ATTRwt-negative HFpEF/HFmrEF. Sparse partial least squares analyses were performed.
The results showed that decorin (DCN), alpha-L-iduronidase (IDUA), and galactosidase β-1 (GLB-1) most effectively distinguished ATTRwt-CM from ATTRwt-negative patients (R2 = 0.71). In a prospective validation cohort (35 ATTRwt-CM, 25 ATTRwt-negative), DCN and IDUA predicted ATTRwt-CM (DCN: OR 3.3, IDUA: OR 0.4). DCN (AUC 0.74; 95% CI, 0.61–0.87; sensitivity, 0.91; specificity, 0.52) and IDUA (AUC 0.78; 95% CI, 0.65–0.91; sensitivity, 0.91; specificity, 0.61) demonstrated moderate discriminative ability.
They concluded that DCN and IDUA biomarkers may serve as useful screening tools for ATTRwt-CM, distinguishing them from other forms of HFpEF/HFmrEF.
Source: academic.oup.com/cardiovascres/advance-article/doi/10.1093/cvr/cvae189/7759338
