Hypertrophic and restrictive cardiomyopathies in the elderly

S. J. Zieman, N. J. Fortuin

Research output: Contribution to journalArticle

Abstract

RCM should be considered in older patients with marked fluid retention, conduction abnormalities, and a normal to small left ventricular cavity with usually normal systolic function. In contrast to early diastolic relaxation impairment seen in hypertrophic disease, signs and symptoms of RCM are caused by compromise in late diastole. Although amyloid is a frequent finding in older hearts at autopsy, most deposits are confined to the atria and are of little clinical significance. Of the pathologic types of amyloidosis, immunoglobulin light chain amyloid most commonly infiltrates the heart and carries the worst prognosis (although survival is slightly better in older than younger patients). Familial amyloidosis is an example of a genetic disease of late-onset phenotypic expression with growing importance in the elderly? Familial amyloidosis carries a more favorable prognosis stressing the significance of accurately diagnosing the type of amyloid by serum immunohistochemistry. The terms systemic senile amyloidosis and senile cardiac amyloidosis have been broadly used to describe the age-related increase in amyloid deposits, regardless of the protein subtype. Normal and genetically altered transthyretin have been identified as the protein precursors of these disorders, reclassifying them as a subset of familial amyloidosis. Symptomatic treatment with diuretics remains the goal of therapy with careful titration to avoid hypotension.

Original languageEnglish (US)
Pages (from-to)159-172
Number of pages14
JournalCardiology Clinics
Volume17
Issue number1
DOIs
StatePublished - 1999

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Familial Amyloidosis
Restrictive Cardiomyopathy
Hypertrophic Cardiomyopathy
Amyloidosis
Amyloid
Immunoglobulin Light Chains
Inborn Genetic Diseases
Prealbumin
Protein Precursors
Diastole
Amyloid Plaques
Diuretics
Hypotension
Signs and Symptoms
Autopsy
Immunohistochemistry
Survival
Therapeutics
Serum
Proteins

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hypertrophic and restrictive cardiomyopathies in the elderly. / Zieman, S. J.; Fortuin, N. J.

In: Cardiology Clinics, Vol. 17, No. 1, 1999, p. 159-172.

Research output: Contribution to journalArticle

Zieman, S. J. ; Fortuin, N. J. / Hypertrophic and restrictive cardiomyopathies in the elderly. In: Cardiology Clinics. 1999 ; Vol. 17, No. 1. pp. 159-172.
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