Transthyretin Amyloid Cardiomyopathy (ATTR-CM): Zizindikiro, Chithandizo, ndi Zambiri

Zamkati

• Kodi zizindikiro za ATTR-CM ndi ziti?
• Nchiyani chimayambitsa ATTR-CM?
• Cholowa (cha banja) ATTR
• Mtundu wamtchire ATTR
• Kodi ATTR-CM imapezeka bwanji?
• Kodi ATTR-CM imathandizidwa bwanji?
• Kodi chiopsezo ndi chiyani?
• Mukuwona bwanji ngati muli ndi ATTR-CM?
• Mfundo yofunika

Transthyretin amyloidosis (ATTR) ndi momwe puloteni yotchedwa amyloid imayikidwa mumtima mwanu, komanso m'mitsempha yanu ndi ziwalo zina. Zitha kubweretsa matenda amtima otchedwa transthyretin amyloid cardiomyopathy (ATTR-CM).

Transthyretin ndi mtundu weniweni wa mapuloteni amyloid omwe adayikidwa mumtima mwanu ngati muli ndi ATTR-CM. Nthawi zambiri imakhala ndi vitamini A ndi mahomoni a chithokomiro mthupi lonse.

Pali mitundu iwiri ya transthyretin amyloidosis: mtundu wamtchire komanso cholowa.

ATTR yamtchire (yomwe imadziwikanso kuti senile amyloidosis) siyimayambitsidwa ndi kusintha kwa majini. Mapuloteni omwe amasungidwa ali osasintha.

Mu cholowa cha ATTR, mapuloteni amapangidwa molakwika (osungunuka). Kenako imagundana ndipo nthawi zambiri imathera munyama ya thupi lanu.

Kodi zizindikiro za ATTR-CM ndi ziti?

Vuto lamanzere lamtima wanu limapopa magazi kudzera mthupi lanu. ATTR-CM imatha kukhudza makoma a chipinda chino chamtima.

Madipoziti a amyloid amapangitsa makoma kukhala olimba, chifukwa chake samatha kupumula kapena kufinya bwinobwino.

Izi zikutanthauza kuti mtima wanu sungathe kudzaza bwino (kuchepetsa diastolic function) ndi magazi kapena kupopera magazi kudzera mthupi lanu (kuchepa kwa systolic function). Izi zimatchedwa kuti cardiomyopathy, yomwe ndi mtundu wa mtima wosalimba.

Zizindikiro za kulephera kwamtima ndi izi:

• kupuma movutikira (dyspnea), makamaka pogona kapena poyesetsa
• kutupa m'miyendo yanu (zotumphukira edema)
• kupweteka pachifuwa
• kuthamanga kosasintha (arrhythmia)
• kugwedeza
• kutopa
• kukulitsa chiwindi ndi nthenda (hepatosplenomegaly)
• madzimadzi m'mimba mwanu (ascites)
• kusowa chakudya
• mutu wopepuka, makamaka pakuimirira
• kukomoka (syncope)

Chizindikiro chapadera chomwe nthawi zina chimachitika ndikuthamanga kwa magazi komwe kumayamba bwino. Izi zimachitika chifukwa mtima wanu ukayamba kuchepa, sungapope mwamphamvu mokwanira kuti magazi anu azithamanga kwambiri.

Zizindikiro zina zomwe mungakhale nazo kuchokera kuma deposits amyloid m'malo ena amthupi kupatula mtima wanu ndi awa:

• matenda a carpal
• kutentha ndi dzanzi m'manja ndi m'miyendo yanu (zotumphukira za m'mitsempha)
• kupweteka kwa msana kwa stenosis ya msana

Ngati mukumva kupweteka pachifuwa, itanani 911 mwachangu.

Pitani kuchipatala nthawi yomweyo mukakhala ndi izi:

• kuwonjezera kupuma movutikira
• kutupa kwamiyendo kwakukulu kapena kunenepa mwachangu
• kuthamanga kwa mtima mwachangu kapena mosasinthasintha
• imapumira kapena kugunda kwa mtima pang'ono
• chizungulire
• kukomoka

Nchiyani chimayambitsa ATTR-CM?

Pali mitundu iwiri ya ATTR, ndipo iliyonse ili ndi chifukwa chake.

Cholowa (cha banja) ATTR

Mu mtundu uwu, transthyretin imasokonekera chifukwa cha kusintha kwa majini. Ikhoza kupititsidwa kuchokera kwa kholo kupita kwa mwana kudzera mu majini.

Zizindikiro nthawi zambiri zimayambira m'ma 50s, koma zimatha kuyamba zaka 20.

Mtundu wamtchire ATTR

Kuchulukanso kwa mapuloteni ndichinthu chofala. Thupi lanu liri ndi njira zochotsera mapuloteniwa asanayambitse vuto.

Mukamakalamba, makinawa amayamba kuchepa, ndipo mapuloteni oyenda molakwika amatha kugundana ndikupanga ndalama. Ndizomwe zimachitika mu mtundu wamtchire wa ATTR.

ATTR yamtundu wamtchire si kusintha kwa majini, chifukwa sichingadutse kudzera majini.

Zizindikiro nthawi zambiri zimayambira m'ma 60s kapena 70s.

Kodi ATTR-CM imapezeka bwanji?

Kuzindikira kumatha kukhala kovuta chifukwa zizindikilo zake ndizofanana ndi mitundu ina ya kulephera kwa mtima. Mayeso omwe amagwiritsidwa ntchito pofufuza ndi awa:

• electrocardiogram kuti muwone ngati makoma amtima ali okuya kuchokera pamadontho (nthawi zambiri magetsi amayenda)
• echocardiogram kuti ayang'ane makoma akuda ndikuwunika momwe mtima ukugwirira ntchito ndikuyang'ana kupumula kosazolowereka kapena zizindikiritso zowonjezereka mumtima
• MRI ya mtima kufunafuna amyloid pakhoma la mtima
• mitsempha ya mtima kufunafuna ma amyloid deposits pansi pa microscope
• maphunziro a majini kufunafuna cholowa cha ATTR

Kodi ATTR-CM imathandizidwa bwanji?

Transthyretin amapangidwa makamaka ndi chiwindi. Pachifukwa ichi, ATTR-CM yobadwa nayo imathandizidwa ndikuyika chiwindi ngati zingatheke. Chifukwa mtima umawonongeka nthawi zonse ngati vutoli lapezeka, nthawi zambiri amaika mtima nthawi yomweyo.

Mu 2019, mankhwala awiri ovomerezeka ochizira ATTR_CM: tafamidis meglumine (Vyndaqel) ndi tafamidis (Vyndamax) makapisozi.

Zina mwazizindikiro za cardiomyopathy zitha kuchiritsidwa ndi okodzetsa kuti achotse madzimadzi owonjezera.

Mankhwala ena omwe amagwiritsidwa ntchito nthawi zambiri kuchiza kulephera kwa mtima, monga beta-blockers ndi digoxin (Lanoxin), atha kukhala owopsa pamkhalidwewu ndipo sayenera kugwiritsidwa ntchito pafupipafupi.

Kodi chiopsezo ndi chiyani?

Zowopsa zakubadwa kwa ATTR-CM ndizo:

• mbiri ya banja la vutoli
• mwamuna kapena mkazi
• zaka zoposa 50
• Mbadwa zaku Africa

Zowopsa za ATTR-CM zamtchire ndizo:

• zaka zoposa 65
• mwamuna kapena mkazi

Mukuwona bwanji ngati muli ndi ATTR-CM?

Popanda kusintha kwa chiwindi ndi mtima, ATTR-CM imakulirakulira pakapita nthawi. Pafupifupi, anthu omwe ali ndi ATTR-CM amakhala atapezeka ndi matenda.

Vutoli limatha kukulitsa moyo wanu, koma kuchiza matenda anu ndi mankhwala kungathandize kwambiri.

Mfundo yofunika

ATTR-CM imayambitsidwa chifukwa cha kusintha kwa majini kapena zokhudzana ndi zaka. Zimabweretsa zizindikilo za kulephera kwa mtima.

Kuzindikira kumakhala kovuta chifukwa cha kufanana kwake ndi mitundu ina ya kulephera kwa mtima. Zimakula pang'onopang'ono pakapita nthawi koma zimatha kuchiritsidwa ndikuyika chiwindi ndi mtima komanso mankhwala othandizira kuthana ndi matenda.

Ngati mukukumana ndi zina mwazizindikiro za ATTR-CM zomwe zidatchulidwa koyambirira, funsani dokotala wanu.