Heart failure & cardiomyopathiesCohort study

Left Ventricular Transthyretin Amyloid Load and Apical Sparing in Patients with Newly Confirmed Transthyretin Amyloid Cardiomyopathy

Eur J Heart FailPublished

  • Prospective cohort study
  • endomyocardial biopsy

Authors' conclusion

Apical sparing reflects advanced myocardial involvement in ATTR-CM and correlates with increased amyloid load and biomarkers in a large endomyocardial biopsy collective.

Study context

Population
Patients with newly diagnosed, biopsy-confirmed wild-type ATTR-CM61 enrolled
Participants
56 patients
Exposure
Relative apical sparing (RELAPS) vs no RELAPS
Outcome
Association of apical sparing (RELAPS) with LV amyloid load on endomyocardial biopsy and clinical phenotype

Main finding

As reported in the abstract

LV amyloid load
  • Significantly higher left ventricular (LV) amyloid load with RELAPS than without

Observational data: associations, not effects.

Further findings

Clinical, laboratory and imaging features

RELAPS associated with elevated NT-proBNP, higher Perugini scores, lower global longitudinal strain (GLS) and atrial strain
No differences in age or wall thickness

Perugini score vs histological amyloid content

Perugini scores failed to distinguish intermediate myocardial amyloid content
71.1%

Original publication

Left Ventricular Transthyretin Amyloid Load and Apical Sparing in Patients with Newly Confirmed Transthyretin Amyloid Cardiomyopathy. Eur J Heart Fail. Published 30 October 2025. doi:10.1002/ejhf.70077

Summarised from the published abstract; every number is checked against it