| Title: |
Sex-specific differences in cardiac transthyretin amyloidosis: addressing the diagnostic gap in women. |
| Authors: |
Vogel, Julia; Jura, Sophia; Settelmeier, Stephan; Lerchner, Tobias; Buehning, Florian; Yahsaly, Loubna; Carpinteiro, Alexander; Reinhardt, H Christian; Rassaf, Tienush; Michel, Lars |
| Source: |
European Heart Journal Open; Jan2026, Vol. 6 Issue 1, p1-9, 9p |
| Subject Terms: |
FEMALES; DELAYED diagnosis; BIOMARKERS; TREATMENT effectiveness; ECHOCARDIOGRAPHY; SEXUAL dimorphism; HEART failure; CARDIAC amyloidosis |
| Abstract: |
Aims Transthyretin amyloid cardiomyopathy (ATTR-CM) is an underdiagnosed cause of heart failure. With a male:female ratio of approximately 10:1, current evidence including diagnostic criteria is largely based on male-dominant collectives. Sex-specific differences may contribute to delayed diagnosis in women. This study investigates these differences in a real-world setting. Methods and results In this retrospective single-centre cohort study, all patients at West German Amyloidosis Center diagnosed with ATTR-CM between 2018 and 2024 were analysed. Clinical, echocardiographic, and laboratory parameters as well as outcomes under transthyretin stabilizer therapy at 6 and 12 months were evaluated. Among 240 patients, 34 (14.2%) were women. Compared to men, women had lower interventricular septal diameter, left ventricular mass, and stroke volume, but higher ejection fraction. Troponin I levels were lower and renal function was worse in women. Diagnostic delay was significantly longer in women (median 750 vs. 86 days, P = 0.022). Despite therapy, sex-specific echocardiographic differences persisted, and functional capacity remained lower in women, although NYHA functional class was comparable. Conclusion Transthyretin amyloid cardiomyopathy presents with persistent sex-specific differences that may contribute to diagnostic delay in women. Current diagnostic thresholds may not adequately reflect female disease patterns, underscoring the need for sex-adapted diagnostic criteria to improve early detection and management. [ABSTRACT FROM AUTHOR] |
| : |
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| Database: |
Complementary Index |