TESTING AND TREATMENT IN AMYLOIDOSIS

BNP stands for a protein called ‘B-type natriuretic peptide.’ This protein is made by the muscles in the heart. NT-proBNP is another protein that is produced when BNP is formed. Both of these proteins increase in amyloidosis and other types of heart disease. They go up when the heart gets stretched because of extra fluid (called ‘congestion’), when amyloidosis gets worse, or if the kidneys are not working well.

This is a protein made by the muscles in your heart. In patients with amyloidosis, it is usually a little higher than normal and it increases as the disease gets worse. It can also be higher in other heart diseases, like heart attacks.

Creatinine and glomerular filtration rate (GFR) are tests that show how well your kidneys are working. Sodium and potassium are electrolytes in your body that the kidneys help control. These tests are often done when you start taking new medications, especially ones that can affect how well your kidneys work and the levels of potassium in your body.

Serum protein electrophoresis (SPEP), urine protein electrophoresis (UPEP), and serum free light chains (SFLC) are tests that check for unusual proteins in your blood or urine. These tests are usually done to diagnose amyloidosis and find out which protein is causing it. If an abnormal protein is found in your blood or urine, you may need more tests to determine if it’s causing your heart disease.

• Treating the symptoms of cardiac amyloidosis usually involves the following:
  • Preventing fluid build-up by reducing salt and fluid intake in the diet, monitoring body weight changes, and taking diuretic medications (sometimes called ‘water pills’).
  • Avoiding certain medications that can worsen symptoms in people with amyloidosis.
  • Treating abnormal heart rhythms with medications to regulate heart rate and prevent complications like stroke.
  • Sometimes using medications, electrical shock (cardioversion), or procedures to restore a normal heart rhythm.
  • Using pacemakers or other implantable heart devices when necessary.
  • Occasionally using medications to prevent low blood pressure.

Different treatments are available to prevent further build-up of amyloid protein, depending on the type of amyloid protein present. These treatments may slow down or stop the disease from progressing in many cases. Your medical team will discuss whether these treatments are suitable for you.

Your medical team will provide important recommendations on lifestyle, including diet and exercise. They might refer you to a special exercise program called cardiac rehabilitation. This program is designed for individuals living with heart disease to improve physical endurance and strength.

You may also be referred to other specialists to help manage different aspects of your condition. These specialists could include blood specialists (hematology), nerve specialists (neurology), digestive system specialists (gastroenterology), kidney specialists (nephrology),elderly medicine specialists (geriatric medicine) or palliative care specialists.