Martha Grogan, M.D., Cardiovascular Medicine, Mayo Clinic: Hi. I’m Doctor Martha Grogan. I’m a cardiologist at the Mayo Clinic, and I ‘d like to go over with you the treatment alternatives for clients who have heart amyloidosis. In previous sectors, we spoke about the medical diagnosis and what amyloid truly is, and now we’ll discuss the treatment choices.
The most crucial thing for you to understand is actually quite basic. The treatment for heart amyloidosis depends totally on which type you have, and in order to develop a medical diagnosis of amyloid you need to initially have what we call a tissue biopsy. Some part of your body has actually been tested and discovered to have amyloid deposits. That can either be from the fat or the bone marrow, the kidney or the heart, or other parts of your body. And as soon as that’s been stained and discovered to have amyloid, then we require to understand especially what type is it? What kind of protein is comprising the irregular amyloid deposits? Pathologists utilize a strategy called mass spectrometry to figure out the kind of amyloid that you have, and it’s really essential to ensure that your specimen has actually been analyzed by somebody who’s extremely skilled in this strategy.
We sadly do not have a particular treatment for heart amyloidosis, so we do not have a medication that will take the amyloid out of the heart. The most fundamental part of treatment is to deal with the hidden protein issue, so we wish to either stop the unusual protein from being produced, or support the protein so that it does not do that misfolding that we spoke about and deposit within the different organs, especially the heart.
For the AL type of amyloid– keep in mind, that one is called light chain, or immunoglobulin-associated amyloidosis– the hematologist is going to be definitely the total secret to your treatment, and a hematologist who’s a specialist in this location will inform you whether or not you’re a prospect for chemotherapy, whether or not you may have a treatment called autologous stem cell transplant, or whether there are brand-new or speculative medications that may be utilized to deal with the AL type of amyloid. Which’s the very best method to attempt to support the heart function.
For the TTR– that’s the transthyretin kind of amyloid– if you have the genetic kind, then the issue is that your liver is making an unusual protein. And liver transplant is a choice for some clients with genetic amyloidosis, and there are quickly going to be a range of various, brand-new medications that will assist attempt to support that protein or perhaps avoid it from being formed.
Now the wild type, or formerly called senile kind of amyloidosis, we do not have particular treatment for that right now, however the exact same kind of medications that are being utilized for familial amyloidosis to support the protein are ideally going to be offered soon as part of medical trials to attempt to stop the procedure of amyloid deposition in clients with this wild type.