Department of Cardiology, Hospital Universitario Puerta de Hierro, Manuel de Falla, 2. Majadahonda, 28222, Madrid, Spain.
Department of Nuclear Medicine, Hospital Universitario Puerta de Hierro, Madrid, Spain.
J Cardiovasc Transl Res. 2019 Dec;12(6):507-513. doi: 10.1007/s12265-019-09895-0. Epub 2019 Jun 18.
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.
腕管综合征（CTS）是心脏淀粉样变性患者的常见表现。我们旨在确定行 CTS 手术患者中心脏淀粉样变性的患病率。2005 年至 2014 年间，308 名年龄≥60 岁的患者接受了 CTS 手术。其中，233 名（76%）同意参与研究，101 名（73±8 岁；68%为女性）出现左心室肥厚（LVH）≥12mm，并进行了其他研究以诊断 AL 和ATTR 淀粉样变性。根据补充研究，三名患者被诊断为心脏淀粉样变性（两例野生型ATTR 和一例 AL）。这三名患者均表现为双侧 CTS，且无职业性危险因素。在整个队列中，心脏淀粉样变性的患病率仅为 1.2%（3/233），但在出现 LVH 和双侧 CTS 的患者中，如果排除有职业性危险因素的病例，患病率分别为 5.5%（3/55）和 13.6%（3/22）。如果存在双侧 CTS，特别是在无职业性危险因素的情况下，应排除心脏淀粉样变性。
