High Prevalence of Cardiac Amyloidosis in Clinically Significant Aortic Stenosis: A Meta-Analysis

Samiullah Arshad, Ythan H. Goldberg, Huzefa Bhopalwala, Nakeya Dewaswala, Nicholas S. Miceli, Emma J. Birks, Gaurang N. Vaidya

Research output: Contribution to journalArticlepeer-review


Background: There is growing evidence of coexistence of aortic stenosis (AS) and transthyretin cardiac amyloidosis (CA). Not screening AS patients at the time of hospital/clinic visit for CA represents a lost opportunity. Methods: We surveyed studies that reported the prevalence of CA among AS patients. Studies that compared patients with aortic stenosis with cardiac amyloidosis (AS-CA) and AS alone were further analyzed, and meta-regression was performed. Results: We identified nine studies with 1,321 patients of AS, of which 131 patients had concomitant CA, with a prevalence of 11%. When compared to AS-alone, the patients with AS-CA were older, more likely to be males, had higher prevalence of carpal tunnel syndrome, right bundle branch block. On echocardiogram, patients with AS-CA had thicker interventricular septum, higher left ventricular mass index (LVMI), lower myocardial contraction fraction, and lower stroke volume index. Classical low-flow low-gradient (LFLG) physiology was more common among patients with ASCA. Patients with AS-CA had higher all-cause mortality than patients with AS alone (33% vs. 22%, P = 0.02) in a follow-up period of at least 1 year. Conclusions: CA has a high prevalence in patients with AS and is associated with worse clinical, imaging, and biochemical parameters than patients with AS alone.

Original languageEnglish (US)
Pages (from-to)357-371
Number of pages15
JournalCardiology Research
Issue number6
StatePublished - 2022


  • Aortic stenosis
  • Cardiac amyloidosis
  • Clinical features
  • Imaging characteristics
  • Mortality
  • Prevalence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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