Transthyretin Cardiac Amyloidosis in Patients With Idiopathic Carpal Tunnel Syndrome Referred for Release Surgery

University Hospital, Toulouse6 enrolled

Overview

This study will determine the prevalence of transthyretin amyloidosis in pathology of the transverse carpal ligament and cardiac involvement using natriuretic peptides, electrocardiography and echocardiography in patients referred for carpal tunnel release surgery of idiopathic carpal tunnel syndrome. This study will describe the relationship between amyloid deposition observed on the transverse carpal ligament and the presence of cardiac involvement.

Unrecognized wild-type transthyretin amyloidosis (ATTRwt) in patients with idiopathic carpal tunnel syndrome (CTS) is a prevalent aging-related disorder. Amyloid deposition in the tenosynovial tissue has been reported in \~35% of patients with idiopathic carpal tunnel syndrome. Otherwise, CTS has been shown to be the most common initial symptom of systemic wild-type transthyretin amyloidosis. The clinical significance of subclinical ATTRwt deposits in the heart in elderly patients has yet to be determined, but these deposits could contribute to the development of heart failure with preserved ejection fraction. ATTRwt has been reported in \~15% of patients with heart failure with preserved ejection fraction. Early detection of amyloid deposition in the transverse carpal ligament of patients with CTS could anticipate cardiac damage and progression to heart failure.The aim of this study is to determine the prevalence of transthyretin amyloidosis in pathology of the transverse carpal ligament and cardiac involvement using natriuretic peptides, electrocardiography and echocardiography in patients referred for carpal tunnel release surgery of idiopathic carpal tunnel syndrome.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Transthyretin Amyloidosis Carpal Tunnel Syndrome

Interventions

Descriptive cohortOTHER

NT-proBNP assay, electrocardiogram and transthoracic echocardiography before CTS surgery release. Pathological analysis for amyloid deposits of transverse carpal ligament of patients included.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients over 18 year-old * Indication carpal tunnel release surgery of idiopathic carpal tunnel syndrome. * To agree to participate (signature of the informed consent) * Affiliate or beneficiary of a social security scheme Exclusion Criteria: * Patients with non-idiopathic carpal tunnel syndrome with medical contraindication : pregnancy, obesity (body mass index \> 30), diabetes, rheumatoid arthritis, sarcoidosis, purulent tenosynovitis, tuberculosis, systemic lupus erythematosus, hypothyroidism or hyperthyroidism and gout. * Patients with history of cardiac disease or coronary artery disease. * Patients with systemic amyloidosis already known. * Patients unde guardianship or curatorship

Locations (1)

Olivier Lairez

Toulouse, France

Outcomes

Primary Outcomes

Cardiac involvement

Prevalence of cardiac involvement in presence of transthyretin amyloid deposition in the transverse carpal ligament of patients with CTS referred for surgery released.

Time frame: 1 day

Secondary Outcomes

Transthyretin amyloid involvement

Prevalence of transthyretin amyloid deposition in the transverse carpal ligament of patients with CTS referred for surgery released. Electrocardiographic features of cardiac involvement in case of presence of transthyretin amyloid deposition in the transverse carpal ligament of patients with CTS referred for surgery released.

Time frame: 1 day

Data from ClinicalTrials.gov

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