**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Pablo Garcia-Pavia, Hospital Universitario Puerta de Hierro Majadahonda University Hospital, Madrid, Spain

**Main Body of the Abstract**
Background: We investigated echocardiogram (echo), magnetic resonance imaging (MRI), and electrocardiogram (ECG) features of transthyretin amyloid cardiomyopathy (ATTR-CM) that may heighten suspicion of amyloid disease and prompt further screening in patients with hypertrophic cardiomyopathy (HCM) who participated in the TTRACK study.
Methods: This global, non-interventional epidemiological study (NCT03842163) included patients ≥50 years of age with HCM of unknown etiology (left ventricular maximum wall thickness ≥15 mm [echo]) undergoing scintigraphy. Cardiac-vs-bone radiotracer uptake on scans was graded using the Perugini system. Monoclonal protein testing was performed to exclude light chain amyloidosis.
Results: Of 766 eligible patients, 521 (68.0%) had no cardiac uptake; 37 (4.8%) had low uptake (grade 1); and 208 (27.2%) had moderate/high uptake (grade 2/3; cardiac amyloidosis [CA]). Among patients with CA,144 (18.8%) had ATTR-CM. Marked numerical differences on echo were observed between patients with no cardiac uptake vs ATTR-CM in mean LV mass index (155.6 vs 179.0 g/m2), preserved apical strain (57.9% vs 73.4% of patients), and concentric hypertrophic pattern (38.8% vs 77.5%) (Table). Although the rate of LV outflow tract (LVOT) obstruction was lower in patients with ATTR-CM vs no cardiac uptake, 12.6% with ATTR-CM had LVOT obstruction. Between-group differences on MRI and ECG are also shown in the Table.
Conclusions: In the TTRACK study, noteworthy differences in some cardiac imaging/ECG findings were seen between patients with HCM with and without ATTR-CM, but none appeared to be definitive. These findings suggest that broader screening for amyloid disease with scintigraphy should be considered among all patients with HCM.



**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Pablo Garcia-Pavia, Hospital Universitario Puerta de Hierro Majadahonda University Hospital, Madrid, Spain

**Main Body of the Abstract**
**Background:** We investigated echocardiogram (echo), magnetic resonance imaging (MRI), and electrocardiogram (ECG) features of transthyretin amyloid cardiomyopathy (ATTR-CM) that may heighten suspicion of amyloid disease and prompt further screening in patients with hypertrophic cardiomyopathy (HCM) who participated in the TTRACK study.
**Methods:** This global, non-interventional epidemiological study (NCT03842163) included patients ≥50 years of age with HCM of unknown etiology (left ventricular maximum wall thickness ≥15 mm [echo]) undergoing scintigraphy. Cardiac-vs-bone radiotracer uptake on scans was graded using the Perugini system. Monoclonal protein testing was performed to exclude light chain amyloidosis.
**Results:** Of 766 eligible patients, 521 (68.0%) had no cardiac uptake; 37 (4.8%) had low uptake (grade 1); and 208 (27.2%) had moderate/high uptake (grade 2/3; cardiac amyloidosis [CA]). Among patients with CA,144 (18.8%) had ATTR-CM. Marked numerical differences on echo were observed between patients with no cardiac uptake vs ATTR-CM in mean LV mass index (155.6 vs 179.0 g/m2), preserved apical strain (57.9% vs 73.4% of patients), and concentric hypertrophic pattern (38.8% vs 77.5%)** **(**Table**). Although the rate of LV outflow tract (LVOT) obstruction was lower in patients with ATTR-CM vs no cardiac uptake, 12.6% with ATTR-CM had LVOT obstruction. Between-group differences on MRI and ECG are also shown in the **Table**.
**Conclusions:** In the TTRACK study, noteworthy differences in some cardiac imaging/ECG findings were seen between patients with HCM with and without ATTR-CM, but none appeared to be definitive. These findings suggest that broader screening for amyloid disease with scintigraphy should be considered among all patients with HCM.



Transthyretin amyloid cardiomyopathy among patients with hypertrophic cardiomyopathy: cardiac imaging and electrocardiographic findings from the TTRACK study PB93 (#19)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.