Cardiac Amyloidosis : Diagnostic Using Red Flag Signals (TEAM Red Flags)
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Cardiac amyloidosis is an increasingly contributor of degenerative cardiac diseases. However, its frequency remains underestimated, and diagnosis is often realized at late stages of the disease. A larger use of clinical and echographic Red Flag signals during routine echocardiographic examination may enhance the identification of early stage of the disease.
Condition or disease
Procedure: diagnostic algorithm
The objective is to evaluate the clinical and epidemiological aspects of cardiac amyloidosis using a systematic screening of even moderate left ventricular hypertrophy, taking into account the presence of Red Flag signals. Red Flag Signals will include history or symptoms of carpal tunnel syndrome, hearing loss, chronic gastrointestinal disorders, heart failure, cervical or lumbar stenosis, or echographic abnormalities such as apical sparring, increased left ventricular filling pressure, atrio-ventricular block.
Frequency of cardiac amyloidosis diagnosed according to Gillmore's algorithm [ Time Frame: 3 months ]
frequency of cardiac amyloidosis diagnosed according to Gillmore's algorithm at the end of the diagnosis procedures, using biological (presence of cell dyscrasia), imaging (myocardial staining of bone tracers), and tissue examination (Congo Red staining) variables
Secondary Outcome Measures :
Frequency genotype of Transthyretin cardiac amyloidosis according to Gillmore's algorithm [ Time Frame: 5 months ]
Evaluate the frequency of Transthyretin cardiac amyloidosis among subjects with even moderate left ventricular enlargement (wall thickness ≥ 12 mm), taking into account the presence or not of Red Flag signals
Distribution of Red Flag signals according to Transthyretin genotype [ Time Frame: 5 months ]
To Compare the distribution of Red Flag signals between wild type TTR cardiac amyloidosis and hereditary TTR cardiac amyloidosis
Diagnosis value of any Red Flag signal. [ Time Frame: 5 months ]
To evaluate the diagnostic performance of each of the Red Flag signals for the diagnosis of TTR cardiac amyloidosis
Elaboration of a pre-test probability score [ Time Frame: 5 months ]
To elaborate a pre-test probability score including the Red Flag signals, adapted to the Echo Lab settings.
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Layout table for eligibility information
Ages Eligible for Study:
45 Years and older (Adult, Older Adult)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
Caribbeans who the large share of populations from African origin may be associated with a high prevalence of Transthyretin amyloidosis.
In this population, diagnosis procedure will be perform to any patient with Left Ventricular Hypertrophy (LVH) with wall thickness ≥ 12 mm associated with clinical manifestations (or Red Flag signals
Diagnosis of left ventricular hypertrophy defined by a parietal thickness (interventricular septum or posterior wall) ≥ 12 mm on the echocardiogram
Age equal or greater than 45 years
Current residency in Martinique, Guadeloupe or French Guyana
Ability to receive and understand research information
Ability to freely deliver informed written consent
Pregnant or breastfeeding woman
Severe uncontrolled hypertension
Person under legal protection measures (guardianship, curatorship, safeguard of justice), and person deprived of liberty