JAMA Cardiology Author Interviews Transthyretin Cardiac Amyloidosis in Older Black and Hispanic Individuals With Heart Failure
Sep 10, 2025
Frederick L. Ruberg, MD, a prominent figure at Boston University and the Amyloidosis Center, discusses the critical impact of transthyretin cardiac amyloidosis on older Black and Hispanic individuals with heart failure. The conversation reveals stark racial and age disparities in prevalence, particularly among men over 75. Ruberg emphasizes the need for improved diagnostic practices that consider gender and ethnicity differences. Early detection strategies and advancements in therapy also take center stage, highlighting the importance of family testing to combat this growing health issue.
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Age-Dependent Risk And Genetic Link
- Cardiac amyloidosis shows age-dependent penetrance and is common after age 60.
- The V122I gene variant disproportionately affects people of West African ancestry and guided cohort selection.
Screen Older HF Patients With Increased Wall Thickness
- Enroll or evaluate older patients (≥60) with heart failure and LV wall thickness ≥12 mm for ATTR.
- Exclude known AL amyloidosis and low EF to focus on earlier, clinically relevant ATTR cases.
Prevalence Increases Sharply With Age
- Overall ATTR prevalence in the study was ~6.5–7% among older Black and Hispanic HF patients with increased wall thickness.
- Prevalence rose with age and reached ~17% in men older than 75 years.