An echo score raises the suspicion of cardiac amyloidosis in Chinese with heart failure with preserved ejection fraction

Abstract Aims Transthyretin cardiac amyloidosis (ATTR‐CA) has been realized as an important cause of heart failure with preserved ejection fraction (HFpEF). We aim to provide insights into its prevalence in Chinese HFpEF patients, which is not known to date, using increased wall thickness (IWT) score by echocardiography. Methods Consecutive patients with HFpEF (EF ≥ 40%) and IWT (≥12 mm) were prospectively screened. Echocardiography was performed, and the IWT score incorporated relative wall thickness, E/e′ ratio, longitudinal strains, and tricuspid annular plane systolic excursion, and septal apical‐to‐base ratio was calculated. ATTR‐CA was defined as score ≥8 in the absence of serum and urine free light chain. Results Six hundred twenty‐four HFpEF patients from January 2019 to December 2021 were enrolled, of which 65.2% were males and the median (interquartile range [IQR]) age was 66 (IQR 57, 73) years. Thirty‐three patients (5.3%, 95% CI 3.5–7.0%) were with score ≥8, and 33.3% were females. They were younger (58 vs. 69 years, P