Cardiac amyloidosis (CA) is now recognized as an important cause of heart failure. Increased wall thickness and diastolic dysfunction of the left ventricle are the most easily detectable manifestations of CA, but amyloid accumulates in all cardiac structures. Involvement of the left and right atria may be due to the haemodynamic effects of ventricular diastolic dysfunction, the effects of amyloid infiltration into the atrial wall, and the cardiotoxic damage of atrial cardiomyocytes by amyloid precursors. Atrial amyloidosis is an early manifestation of CA, and is associated with an increased risk of atrial fibrillation and thromboembolic events. Furthermore, atrial amyloidosis can be found even in the absence of systemic disease and ventricular involvement. This condition is named isolated atrial amyloidosis and is due to a local overproduction of atrial natriuretic peptide. In this review we summarize the evidence on the mechanisms and clinical relevance of atrial amyloidosis.

中文翻译：

---

心房淀粉样变性：机制和临床表现

心脏淀粉样变性（CA）现在被认为是心力衰竭的重要原因。左心室壁厚增加和舒张功能障碍是 CA 最容易检测到的表现，但淀粉样蛋白在所有心脏结构中积累。左右心房受累可能是由于心室舒张功能障碍的血流动力学影响、淀粉样蛋白浸润心房壁的影响以及淀粉样蛋白前体对心房心肌细胞的心脏毒性损伤。心房淀粉样变性是 CA 的早期表现，与心房颤动和血栓栓塞事件的风险增加有关。此外，即使在没有全身性疾病和心室受累的情况下，也可以发现心房淀粉样变性。这种情况被命名为孤立性心房淀粉样变性，是由于局部心房钠尿肽产生过多所致。在这篇综述中，我们总结了心房淀粉样变性的机制和临床相关性的证据。