Cardiac Amyloidosis : Diagnostic Using Red Flag Signals

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Early Echographic Screening of Cardiac Amyloidosis Using Red Flag Signals

Conditions
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Cardiac Amyloidosis

Intervention / Treatment
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* Procedure: diagnostic algorithm


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 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 Exclusion Criteria: Pregnant or breastfeeding woman Severe uncontrolled hypertension Chronic hemodialysis Person under legal protection measures (guardianship, curatorship, safeguard of justice), and person deprived of liberty

Ages Eligible for Study
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Minimum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: diagnostic algorithm|Cardiac amyloidosis diagnosed according to Gillmore's algorithm|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frequency of cardiac amyloidosis diagnosed according to Gillmore's algorithm | 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 | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frequency genotype of Transthyretin cardiac amyloidosis according to Gillmore's algorithm | 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 | 5 months | 
| Distribution of Red Flag signals according to Transthyretin genotype | To Compare the distribution of Red Flag signals between wild type TTR cardiac amyloidosis and hereditary TTR cardiac amyloidosis | 5 months | 
| Diagnosis value of any Red Flag signal. | To evaluate the diagnostic performance of each of the Red Flag signals for the diagnosis of TTR cardiac amyloidosis | 5 months | 
| Elaboration of a pre-test probability score | To elaborate a pre-test probability score including the Red Flag signals, adapted to the Echo Lab settings. | 5 months |