Carpal Tunnel Syndrome and Amyloid Cardiomyopathy
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Cardiology, Orthopedic, Hematology |
| Therapuetic Areas: | Cardiology / Vascular Diseases, Hematology, Orthopedics / Podiatry |
| Healthy: | No |
| Age Range: | 50 - Any |
| Updated: | 12/8/2018 |
| Start Date: | March 2016 |
| End Date: | May 2021 |
The investigators will prospectively evaluate tissue samples obtained from patients
undergoing carpal tunnel release surgery for amyloid in the soft tissue that is removed.
Patients who have tissue that stains positive for amyloid will undergo cardiac testing to
look for evidence of cardiac involvement.
undergoing carpal tunnel release surgery for amyloid in the soft tissue that is removed.
Patients who have tissue that stains positive for amyloid will undergo cardiac testing to
look for evidence of cardiac involvement.
Since the 1970s, the connection between amyloidosis and carpal tunnel syndrome has been
described, with tenosynovial tissue staining positive for amyloid fibril deposition. Up to
30% of patients in prior studies with idiopathic carpal tunnel syndrome have biopsy tissue
that stains positive for amyloid deposition. However, the prevalence of cardiac involvement
at the time of carpal tunnel syndrome surgery has not been established. Furthermore, the role
of TTR kinetic stability in the disease progression of amyloidosis is unclear.
Diagnosing TTR amyloidosis at the time of carpal tunnel involvement could lead to an earlier
identification of the disease at a stage where the cardiomyopathy may be occult or less
advanced. In addition, abnormal TTR kinetics may even precede tissue deposition in the flexor
tendon retinaculum. As several emerging pharmacological strategies are in development that
may slow or even halt TTR amyloidosis, earlier diagnosis is advantageous. Identification and
implementation of therapy for prevention or early disease treatment may alter the natural
history of this progressive systemic disease.
described, with tenosynovial tissue staining positive for amyloid fibril deposition. Up to
30% of patients in prior studies with idiopathic carpal tunnel syndrome have biopsy tissue
that stains positive for amyloid deposition. However, the prevalence of cardiac involvement
at the time of carpal tunnel syndrome surgery has not been established. Furthermore, the role
of TTR kinetic stability in the disease progression of amyloidosis is unclear.
Diagnosing TTR amyloidosis at the time of carpal tunnel involvement could lead to an earlier
identification of the disease at a stage where the cardiomyopathy may be occult or less
advanced. In addition, abnormal TTR kinetics may even precede tissue deposition in the flexor
tendon retinaculum. As several emerging pharmacological strategies are in development that
may slow or even halt TTR amyloidosis, earlier diagnosis is advantageous. Identification and
implementation of therapy for prevention or early disease treatment may alter the natural
history of this progressive systemic disease.
Inclusion Criteria:
- Males ≥ 50 years of age
- Females ≥ 60 years of age
- Undergoing carpal tunnel release surgery (adequate symptoms are not responding to
conservative management requiring surgery)
- Able to consent
- Underwent carpal tunnel surgery and biopsy within last 30 days, if the study was
discussed prior to surgery by one of the study physicians.
Exclusion Criteria:
- Secondary CTS (Hemodialysis, rheumatoid arthritis, trauma)
- Known diagnosis of amyloidosis
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