Martha Grogan, M.D., Cardiovascular Medicine, Mayo Clinic: Hi, I’m Dr. Martha Grogan, and I’m a cardiologist at the Mayo Clinic, and today I want to go over with you some details worrying a condition called heart amyloidosis. And if you’re enjoying this, it’s most likely due to the fact that either you or somebody near to you has actually been identified with heart amyloidosis. And this is a really frightening thing, however you actually can not beat any illness up until you comprehend it. My objective today is to evaluate what every client requires to understand about heart amyloidosis. Initially of all, what is amyloid? How does it impact your heart? I’ll discuss the tests that you require to examine your heart– essentially, what do all those numbers indicate? And what are your treatment choices if you have heart amyloidosis?
Well, amyloid is an illness of what we call protein misfolding. There are typically soluble proteins in your blood stream that for a range of factors end up being insoluble, and they transfer unusually in the tissues and organs throughout your body. They can transfer in the kidney, the digestive system, the carpal tunnel ligaments, and the heart and other structures.
Why does that occur? Well, there are 3 primary type of amyloid that really can impact the heart, and there are over 20 proteins that can form amyloid, however just actually 3 that impact the heart. Initially we’ll talk about those. The very first type is called AL amyloid, and the A represents amyloid and L mean light chain type. And this is an immunoglobulin, a protein that is usually made to combat infection. You have unusual cells in your bone marrow that are making too much of these light chains, and they form to then form amyloid protein that transfers in the organ and tissues of your body. In this case, the primary issue are the cells in the bone marrow that are making too numerous light chains. And the AL kind of amyloid typically impacts several organs. It can impact the heart, the kidneys, the intestinal system, and the nerve system.
The other primary kind of amyloid that can transfer in the heart is what’s called transthyretin amyloid, and it’s called due to the fact that the protein that all of us in fact have in our body. It carries thyroid hormonal agent and retinol, which is vitamin A. The letters TTR are for transportations, thyroid hormonal agent and retinol. We abbreviate that as TTR. And there are 2 kinds of TTR amyloid that can impact your heart. The very first type is what’s called genetic or in some cases called familial amyloid, and because type, a person has an anomaly that makes the protein unusual. The TTR protein has a various structure that makes it unsteady, and it tends to form this amyloid fibral that then gets transferred throughout your body. The genetic type of TTR amyloid most typically impacts the nerves and can trigger neuropathy, or it impacts the heart or often both.