**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.**
Mazen Hanna, MD   , Cleveland Clinic,  Cleveland, OH

**Main Body of the Abstract**
Background: Amyloid deposits can be found in tenosynovial tissue at the time of carpal tunnel release surgery (CTRS). It is unclear in real world practice if a prospective screening algorithm can make a substantial number of early cardiac diagnoses.
Methods: A protocol was developed in 2018 at the Cleveland Clinic to screen for amyloid deposition in the tenosynovium with Congo red staining at the time of CTRS in patients with bilateral symptoms (unilateral symptoms with other risk factors) over age 50 for men and 60 for women. If positive, typing by mass spectrometry and cardiac testing with NTproBNP, Troponin, ECG, Echocardiogram, and cardiac scintigraphy was performed.
Results: A total of 1186 patients had tenosynovial biopsies of which 199 (16.7%) demonstrated Congo red positivity. Typing by mass spectrometry showed 100 TTR, 15 light chain, 2 both TTR and light chain, and 82 untyped due to inadequate amount of amyloid.  Among patients who completed cardiac testing, 17 of 77 (22%) with TTR deposits and 8 of 42 (24%) with untyped deposits were diagnosed with cardiac amyloidosis by scintigraphy (AL excluded in untyped patients) or endomyocardial biopsy with a median NT pro BNP of 294 pg/ml and septal thickness of 1.3 cm (range 0.7-1.8). No patients with light chain deposits had cardiac or systemic involvement.
Conclusion:  Screening for amyloid at the time of CTRS yielded a significant number of patients with TTR cardiac amyloidosis at baseline, and patients with untyped amyloid deposits had similar rates of cardiac involvement as those with TTR deposits



**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.**
Mazen Hanna, MD   , Cleveland Clinic,  Cleveland, OH

**Main Body of the Abstract**
**Background**: Amyloid deposits can be found in tenosynovial tissue at the time of carpal tunnel release surgery (CTRS). It is unclear in real world practice if a prospective screening algorithm can make a substantial number of early cardiac diagnoses.
**Methods**: A protocol was developed in 2018 at the Cleveland Clinic to screen for amyloid deposition in the tenosynovium with Congo red staining at the time of CTRS in patients with bilateral symptoms (unilateral symptoms with other risk factors) over age 50 for men and 60 for women. If positive, typing by mass spectrometry and cardiac testing with NTproBNP, Troponin, ECG, Echocardiogram, and cardiac scintigraphy was performed.
**Results**: A total of 1186 patients had tenosynovial biopsies of which 199 (16.7%) demonstrated Congo red positivity. Typing by mass spectrometry showed 100 TTR, 15 light chain, 2 both TTR and light chain, and 82 untyped due to inadequate amount of amyloid.  Among patients who completed cardiac testing, 17 of 77 (22%) with TTR deposits and 8 of 42 (24%) with untyped deposits were diagnosed with cardiac amyloidosis by scintigraphy (AL excluded in untyped patients) or endomyocardial biopsy with a median NT pro BNP of 294 pg/ml and septal thickness of 1.3 cm (range 0.7-1.8). No patients with light chain deposits had cardiac or systemic involvement.
**Conclusion:**  Screening for amyloid at the time of CTRS yielded a significant number of patients with TTR cardiac amyloidosis at baseline, and patients with untyped amyloid deposits had similar rates of cardiac involvement as those with TTR deposits



Screening for Amyloidosis at the time of Carpal Tunnel Release Surgery in Real World Practice is a Successful Strategy at Diagnosing Early Cardiac Amyloidosis  OA4 (#564)

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.