Impact of Tafamidis on Echocardiographic Cardiac Function of Patients With Transthyretin Cardiac Amyloidosis

Background: The efficacy of a therapy for patients with transthyretin amyloid cardiomyopathy (ATTn-CM) has not been proven, but tafamidis has been associated with favorable outcomes. However, echocardiographic details of the association of tafamidis with cardiac morphology remain undetermined. Moreover, whether the efficacy of tafamidis varies with the degree of cardiac involvement remains unknown. Using echocardiography, this study investigated the impact of tafamidis on the cardiac morphology of patients with ATTn-CM. Methods and Results: Of 52 consecutive patients with biopsy-proven ATTn-CM at Kobe University Hospital, we included 41 for whom details of follow-up echocardiographic examinations after the administration of tafamidis were available. All patients underwent standard and speckle-tracking echocardiography before and a mean (+/- SD) of 16 +/- 8 months after the administration of tafamidis. No significant changes were observed in any representative echocardiographic parameters after the administration of tafamidis. Fur-thermore, there were no significant changes observed in subgroup analyses (e.g., left ventricular [LV] ejection fraction >= 50% vs. <50%; LV mass index <150 vs. >= 150 g/m2; New York Heart Association Class I-II vs. Class III; age >= 80 vs. <80 years). Conclusions: Tafamidis may prevent worsening of various representative echocardiographic parameters of patients with ATTn-CM. This effect is also seen in patients with relatively advanced disease and in those who are elderly.