Transcript
Announcer:
This is Heart Matters on ReachMD. Today, we’ll hear from Dr. Alex Reyentovich, who’s a professor in the Department of Medicine at NYU Grossman School of Medicine and the Co-Director of the Amyloidosis Program at the Perlmutter Cancer Center at NYU Langone Health. He’ll be discussing how community providers and amyloidosis specialists can work together to improve care for patients with transthyretin amyloid cardiomyopathy, or ATTR-CM. Let’s hear from Dr. Reyentovich now.
Dr. Reyentovich:
Most patients who have amyloid will be cared for in the community. But there's an evolving understanding of how patients are going to respond to therapy, and there are many trials and registries that are critical for us to advance this disease. So I would make the case that every patient that has amyloid should at least be plugged into an amyloid center of excellence. Now, that doesn't mean they should get all their care there or dissolve their relationship with their community doctors. But they should at least plug in so they understand what the state of the disease is, understand what their mutation is, and if they have a variant type of amyloid, to give their family the information on the natural history of the disease and how their family should be screened.
And then I think having a good partnership with the community to continue to care for that patient and create a bilateral line of communication where the patient can stay in the community, but only really check in if they need to, or on occasion, depending on how sick they are. So I think that if a community provider is going to take care of an amyloid patient, they have to get a sense of who they're going to partner with when things get complicated.
I think a critical part is awareness. Just an awareness and interest in the disease will get more patients diagnosed—an understanding that if you're waiting until someone develops bad heart failure, then that's probably too late. There’s interesting links that I think industry plus academics have put out there—a combination of heart failure and ligamentous involvement, heart failure and spinal stenosis, or heart failure and carpal tunnel, or someone who has bilateral carpal tunnel and spinal stenosis—when people start to accumulate these things that we see in amyloid patients, I think people should say, "Hmm." Especially the ligamentous stuff, the carpal tunnel, and spinal stenosis; that tends to precede the cardiac involvement by many years. So I think if people are starting to take an interest in it and have a partner that is comfortable with evaluating them, you're going to make a lot more diagnoses.
Announcer:
That was Dr. Alex Reyentovich discussing how collaboration between community providers and specialists can improve ATTR-CM care. To access this and other episodes in this series, visit Heart Matters on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
