By Dr. Kelly McCants MD
Medical Director
Advanced Heart Failure Program
Institute for Health Equity
Norton Health Care
Louisville, Ky.
鈥淲hat is heart failure?,鈥 asks Dr. Kelly McCants, Medical Director, Advanced Heart Failure Program at Norton Health Care in Louisville Ky., at the start of a virtual program titled 鈥淰oices for the Heart鈥 hosted by New Prospect Baptist Church in Roselawn earlier this month. 鈥
鈥淚t is a serious condition in which your heart becomes weak, damaged or stiff during which the heart does not pump blood as well as it should. Unfortunately, it usually gets worse, resulting in high blood pressure or a heart attack.鈥
Symptoms include losing weight with no known reason, feeling light-headed when you stand up, shortness of breath, swelling in legs, irregular heartbeat, as well as other symptoms.
And the pay attention kicker to this introduction is this special type of heart failure McCants was聽describing – known as hATTR-CM or hereditary transthyretin amyloid cardiomyopathy – is more likely to affect Black, African Americans and Afro Caribbean men and women ages 50-60. It is hereditary. Whites also can have the condition, but it is not inherited by that race, is usually associated with White men, and it is associated with aging.
hATTR amyloidosis is a rare and rapidly progressive condition caused by a variant, or change, in the transthyretin (TTR) gene. This change in the TTR gene may also be referred to as a mutation.
According to the Cleveland Clinic, there isn鈥檛 a cure for transthyretin amyloidosis (ATTR-CM). And there鈥檚 no way to rid the body of existing amyloid deposits. But medications can halt disease progression by slowing or stopping the buildup of protein deposits. You may also receive treatments to ease symptoms caused by other problems like heart failure, arrhythmias and neuropathy.
Certain medications for familial ATTR-CM bind to the TTR protein. These medicines stabilize the condition and stop proteins from misfolding and hindering the functions of various organs in聽 the body.聽
It runs in the family. If one parent has hATTR amyloidosis,聽each child will have a 50% chance聽of inheriting the genetic variant that causes the condition. A family member may inherit the TTR gene variant, but having the variant does not necessarily mean they will develop hATTR amyloidosis. The age that symptoms typically appear ranges from聽the mid-20s to mid-60s
鈥淎TTR-CM is often over looked by the individuals who carry it, as well as their health care providers, McCants added. 鈥淎TTR-CM聽is an extremely rare condition, and for this reason, it is often diagnosed late. Also, unlike other cardio symptoms, ATTR-CM does not respond to other health care.鈥欌櫬
What happens inside your body when you have ATTR-CM? McCants said TTR proteins, which are a serum and cerebrospinal fluid carrier of the thyroid hormone thyroxine, become tangled, causing stiffening in various parts of body that leads to the symptoms described above.
鈥淔rom 3 to 4 percent of African Americans (one in聽 of every 1,600 have hATTR-CM. And heart failure聽
in various forms affects 1 in 10 Black adults, according to McCants figures. The number 1 reason Blacks are affected by heart disease is almost always due to hypertension, which is not always treated, and which can be controlled by medications, exercise, and reducing the amount of sodium ingested.
So, he advises that if you have the signs of heart failure described here, have a conversation with your health care provider soon; get tests of how your heart is working; test to see if you have ATTR-CM; and have genetic tests to determine if what you have is hereditary or wild.