**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.**
Ricardo Torres, University of Cincinnati Medical Center, Cincinnati, OH, USA

**Main Body of the Abstract**
A 68-year-old male was referred for evaluation of aortic stenosis (AS). His history included atrial fibrillation, bilateral carpal tunnel syndrome, and lumbar spinal stenosis. Two years prior, an echocardiogram showed mild AS. Repeat echocardiogram showed low-flow low-gradient severe AS, LVEF 40-45%, and grade III diastolic dysfunction. Coronaries were normal by angiography. He underwent aortic valve replacement (AVR) complicated by complete heart block requiring permanent pacemaker.
LVEF improved post AVR but worsened to 35-40% within 1 year and was initially suspected secondary to high ventricular pacing burden. Bi-ventricular pacer was placed and GDMT was titrated. A follow-up echocardiogram revealed moderate to severe cardiomyopathy; LV global longitudinal strain showed relative apical sparing pattern suggestive of cardiac amyloid.  Biochemical tests were negative. Tc-99m pyrophosphate scan was strongly positive for cardiac ATTR amyloidosis (ATTR-CA) by quantitative and semiquantitative criteria. MRI showed diffuse contrast uptake within the myocardium consistent with cardiac amyloidosis. Genetic testing was negative. GDMT was discontinued and Tafamidis was started.
The prevalence of ATTR-CA is high in patients with AS and the coexistence of both conditions confers a worse prognosis. Prior to the diagnosis of AS, our patient had clinical features of amyloidosis, but the diagnosis was made several years after. Early identification of patients with severe AS at risk for ATTR-CA may allow prompt initiation of disease modifying therapy, treatment of associated comorbidities and discontinuation of therapies with no survival or symptomatic benefit. Implementation of diagnostic algorithms ATTR-CA at the time of AS diagnosis may lead to improved outcomes.



Concomitant Aortic stenosis and ATTR Amyloidosis PB87 (#514)

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.