Transthyretin amyloidosis exhibits a variety of possible phenotypes, the hereditary neurological form being the most commonly found and studied (familial amyloidotic polyneuropathy or FAP), which can present from oligosymptomatic patients to patients with peripheral sensorimotor polyneuropathy of varying degrees and dysautonomia. Although a specific mutation usually causes a specific phenotype, that is, with a predominantly cardiac or preferential neurological profile, with the increase in the number of diagnosed cases, an overlapping of clinical presentations has been observed. The assessment of the autonomic profile in individuals with familial amyloidotic cardiomyopathy (FAC) has not been well studied, and it is not known whether patients with an exclusively cardiac profile of the disease may present dysautonomia or whether even mutation carriers without cardiac involvement may exhibit it. In this study, the autonomic profiles of patients with familial amyloidotic heart disease will be compared with the profiles of patients who have mutations but without established heart disease and healthy individuals (control group).
Study Type
OBSERVATIONAL
Enrollment
60
Autonomic response assessment in the orthostatic head up tilt test.
Assessment of heart rate variability on 24-hour Holter monitoring..
Instituto do Coração - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
São Paulo, São Paulo, Brazil
University of Sao Paulo Medical School - The Heart Institute
São Paulo, Brazil
Fabio Fernandes
São Paulo, Brazil
Autonomic response profile of patients with FAC.
To compare the autonomic profile by analyzing the heart rate variability on 24 hours Holter monitoring, the patterns of chronotropic and pressure response and the valsalva maneuver in the tilt table test of patients with FAC, with individuals with mutations of the transthyretin gene without FAC and in healthy individuals.
Time frame: 6 months
Correlation between dysautonomia and electrophysiological cardiac disturbances.
Evaluate the relationship of dysautonomia with atrioventricular, intraventricular, interventricular conduction disturbances, presence of late potentials in the high-resolution electrocardiogram and occurrence of supraventricular and ventricular arrhythmias on Holter monitoring.
Time frame: 6 months
Correlation between dysautonomy and structural cardiac alterations.
Evaluate the relationship of dysautonomia changes with cardiac structural changes assessed by strain echocardiography.
Time frame: 6 months
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