IJCS | Volume 31, Nº4, July / August 2018

460 Jorge et al Cardiac amyloidosis Int J Cardiovasc Sci. 2018;31(4)457-460 Case Report cardiomyopathy is obtained from an endomyocardial biopsy using Congo red or thioflavin staining 2,9 technique and identifying the type of amyloid infiltrate by molecular genetic techniques. The gold standard for the diagnosis of amyloidosis is the myocardial biopsy. The guidelines of the American Heart Association/American College of Cardiology Foundation show a II-A recommendation for endomyocardial biopsy in the presence of HF associated with unexplained restrictive cardiomyopathy. 10 The abdominal fat biopsy can confirm the diagnosis in 70% of cases and, in this reported case, amyloidosis was confirmed by the abdominal biopsy. The prognosis of patients with amyloidosis is reserved. The mean untreated survival is 13 months and may be extended to 17 months with melphalan and prednisone, which in this case were not used due to the patient’s clinical worsening. The cardiac impairment makes the prognosis even worse, with a life expectancy of approximately 6 months. Author contributions Conception and design of the research: Jorge AJL, Avila D, Ribeiro ML, Bruno KEH, Pires C; Acquisition of data: Jorge AJL, Avila D, Vilar EG, Ribeiro ML, Bruno KEH, Pires C; Analysis and interpretation of the data: Jorge AJL, Avila D, Bruno KEH; Writing of the manuscript: Jorge AJL, Avila D, Pires C; Critical revision of the manuscript for intellectual content: Jorge AJL. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This study is not associated with any thesis or dissertation work. 1. Maurer MS, Elliott P, Comenzo R, Semigran M, Rapezzi C. Addressing common questions encountered in the diagnosis and management of cardiac amyloidosis. Circulation. 2017;135(14):1357-77. 2. Mesquita ET, Jorge AJ, Souza CV Junior, Andrade TR. Cardiac amyloidosis and its new clinical phenotype: heart failure with preserved ejection fraction. Arq Bras Cardiol. 2017;109(1):71-80. 3. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016;18(8):891-975. 4. Murtagh B, Hammill SC, Gertz MA, Kyle RA, Tajik AJ, Grogan M. Electrocardiographic findings in primary systemic amyloidosis and biopsy-proven cardiac involvement. Am J Cardiol. 2005;95(4):535-7. 5. Gillmore JD, Maurer MS, Falk RH, Merlini G, Damy T, Dispenzieri A, et al. Nonbiopsy diagnosis of cardiac transthyretin amyloidosis. Circulation. 2016;133(24):2404-12. 6. Sperry BW, Vranian MN, Hachamovitch R, Joshi H, Ikram A, Phelan D, et al. Subtype-specific interactions and prognosis in cardiac amyloidosis. J Am Heart Assoc. 2016;24(3):e002877. 7. Dubrey SW, Hawkins PN, Falk RH. Amyloid diseases of the heart: assessment, diagnosis, and referral. Heart. 2011;97(1):75-84. 8. Liu D, Niemann M, Hu K, Herrmann S, Störk S, Knop S, et al. Echocardiographic evaluation of systolic and diastolic function in patients with cardiac amyloidosis. Am J Cardiol. 2011;108(4):591-8. 9. PhelanD, Collier P, Thavendiranathan P, Popović ZB, HannaM, Plana JC, et al. Relative apical sparing of longitudinal strain using two-dimensional speckle-tracking echocardiography is both sensitive and specific for the diagnosis of cardiac amyloidosis. Heart. 2012;98(19):1442-8. 10. Cooper LT, Baughman KL, Feldman AM, Frustaci A, Jessup M, Kuhl U, et al; American Heart Association; American College of Cardiology; European Society of Cardiology. The role of endomyocardial biopsy in themanagement of cardiovascular disease: a scientific statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology. Circulation. 2007;116(19):2216-33. References This is an open-access article distributed under the terms of the Creative Commons Attribution License