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Prevalence of Cardiac Amyloidosis in Patients with Carpal Tunnel Syndrome

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Abstract

Carpal tunnel syndrome (CTS) is a common finding among patients with cardiac amyloidosis. We sought to determine the prevalence of cardiac amyloidosis in patients who had undergone CTS surgery. From 2005 to 2014, 308 patients ≥ 60 years underwent CTS surgery. Of these, 233 (76%) agreed to participate in the study and 101 (73 ± 8 years; 68% females) showed left ventricular hypertrophy (LVH) ≥ 12 mm and underwent additional studies to diagnose AL and ATTR amyloidosis. Based on complementary studies, three patients were diagnosed with cardiac amyloidosis (two wild-type ATTR and one AL). The three patients showed bilateral CTS with no occupational risk factors. Prevalence of cardiac amyloidosis in the overall cohort was only 1.2% (3/233), but among patients with LVH and bilateral CTS, the prevalence was 5.5% (3/55) and 13.6% (3/22) if cases with an occupational risk factor were excluded. Cardiac amyloidosis should be excluded in the presence of bilateral CTS and particularly if an occupational risk factor is absent.

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Funding

This work was partially supported by Pfizer Inc. through an Investigator Initiated Research Grant to P.G-P. Pfizer Inc. played no role in the design, collection, analysis, or interpretation of the data or in the decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Department of Cardiology, Hospital Universitario Puerta de Hierro, Manuel de Falla, 2. Majadahonda, 28222, Madrid, Spain

    Isabel Zegri-Reiriz, Fernando Dominguez, Esther Gonzalez-Lopez & Pablo Garcia-Pavia

  2. Department of Nuclear Medicine, Hospital Universitario Puerta de Hierro, Madrid, Spain

    F. Javier de Haro-del Moral

  3. CIBER in Cardiovascular Diseases (CIBERCV), Madrid, Spain

    Fernando Dominguez, Clara Salas, Esther Gonzalez-Lopez & Pablo Garcia-Pavia

  4. Myocardial Biology Programme, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain

    Fernando Dominguez & Esther Gonzalez-Lopez

  5. Department of Pathology, Hospital Universitario Puerta de Hierro, Madrid, Spain

    Clara Salas

  6. Department of Orthopaedics and Traumatology, Hospital Universitario Puerta de Hierro, Madrid, Spain

    Pablo de la Cuadra

  7. Department of Immunology, Hospital Universitario Puerta de Hierro, Madrid, Spain

    Aresio Plaza

  8. Department of Hematology, Hospital Universitario Puerta de Hierro, Madrid, Spain

    Isabel Krsnik

  9. University Francisco de Vitoria (UFV), Pozuelo de Alarcón, Madrid, Spain

    Pablo Garcia-Pavia

Authors
  1. Isabel Zegri-Reiriz
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  2. F. Javier de Haro-del Moral
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  3. Fernando Dominguez
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  4. Clara Salas
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  5. Pablo de la Cuadra
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  6. Aresio Plaza
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  7. Isabel Krsnik
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  8. Esther Gonzalez-Lopez
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  9. Pablo Garcia-Pavia
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Corresponding author

Correspondence to Pablo Garcia-Pavia.

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Conflict of Interest

EGL reports consulting and speaking fees from Pfizer. PGP reports consulting fees from Akcea, Alnylam, Eidos, Neuroinmmune, Pfizer and Prothena; speaking fees from Akcea, Alnylam, Eidos, Pfizer and Prothena; and research funding from Alnylam, Pfizer and Prothena. Other authors have no conflict of interest relevant to this work to declare.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Associate Editor Mazen Hanna oversaw the review of this article

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Zegri-Reiriz, I., de Haro-del Moral, F.J., Dominguez, F. et al. Prevalence of Cardiac Amyloidosis in Patients with Carpal Tunnel Syndrome. J. of Cardiovasc. Trans. Res. 12, 507–513 (2019). https://doi.org/10.1007/s12265-019-09895-0

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