# Cardiale amyloïdose komt frequent voor bij HFpEF, aortastenose en LVH — meta-analyse

*geplaatst 2026-08-10 · Hartfalen · ESC heart failure · doi 10.1093/eschf/xvag172 · https://hartvaat.nl/2026/06/22/cardiale-amyloidose-komt-frequent-voor-bij-hfpef-aortastenose-en-lvh-meta-analys/*

Een meta-analyse van 83 studies toont aan dat cardiale amyloïdose (CA) relatief frequent wordt gevonden bij patiënten met HFpEF/HFmrEF (12,6%), ernstige aortastenose (9,6%) en linkerventrikelhypertrofie (15,1%). De prevalentie stijgt aanzienlijk wanneer alleen patiënten worden getest die aan confirmatoire criteria voldoen, met percentages tot 35,4% bij LVH/HCM. Voor de klinische praktijk benadrukt de studie het belang van gestructureerde screening en duidelijke verwijscriteria, in plaats van selectief testen op basis van vermoeden.

## English: Prevalence of cardiac amyloidosis in screening studies: a systematic review and meta-analysis.

A meta-analysis of 83 studies reveals that cardiac amyloidosis (CA) is relatively prevalent in patients with HFpEF/HFmrEF (12.6%), severe aortic stenosis (9.6%), and left ventricular hypertrophy (15.1%). Prevalence estimates rise substantially when only patients meeting confirmatory testing criteria are evaluated, reaching up to 35.4% in LVH/HCM cohorts. Clinically, the findings underscore the need for structured screening pathways and clear referral criteria rather than selective testing based on clinical suspicion alone.

## Abstract (original, from the publication)

BACKGROUND: Cardiac amyloidosis (CA) is an under-recognized cause of heart failure. Its prevalence in screening studies, and the extent to which selective confirmatory testing affects prevalence estimates, remain uncertain across clinical settings. METHODS: We systematically searched PubMed/MEDLINE and EMBASE up to 10 August 2025. Two reviewers independently screened studies and extracted data. We grouped studies by clinical setting and combined prevalence estimates using random-effects meta-analysis. For each study, we calculated CA prevalence in 1) the whole enrolled cohort and 2) the subgroup who underwent confirmatory testing. RESULTS: Eighty-three studies were included. Pooled CA prevalence (whole cohort; tested subgroup) was highest in left ventricular hypertrophy/hypertrophic cardiomyopathy [LVH/HCM] (15.1%; 35.4%), followed by heart failure [HF]-mainly HF with preserved or mildly reduced ejection fraction (HFpEF/HFmrEF)-(12.6%; 13.6%) and aortic stenosis [AS] (9.6%; 11.6%). Orthopedic cohorts were lower overall (4.1%) but higher in tested subgroups (12.4%); "no specific red flags" showed 1.8% vs. 7.8%; non-cardiac bone scintigraphy was 0.49% in both denominators. Across settings, transthyretin CA predominated over light-chain CA. Several studies approached systematic screening in the general elderly; however, they were few and still applied referral criteria to second-level examinations. CONCLUSION: This meta-analysis shows that CA is relatively frequent in HFpEF/HFmrEF, severe AS, and LVH/HCM. To obtain reliable population estimates, future studies should test either all eligible participants or a predefined random sample, rather than only those with suspected disease. In clinical practice, screening strategies should clearly define which higher-risk individuals are referred for second-level tests, balancing diagnostic yield with feasibility.

Auteurs: Alberto Aimo, Vincenzo Castiglione, Giorgia Panichella, Marianna Fontana, Michele Emdin, Giuseppe Vergaro

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Bron: ESC heart failure, https://doi.org/10.1093/eschf/xvag172. Bijgewerkt 2026-08-10T11:07:50Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.