Heart failure with preserved ejection fraction, atrial fibrillation, and the role of senile amyloidosis.

Heart failure with preserved ejection fraction and AF are very common diseases that also often occur in combination, further aggravating each other. Senile amyloidosis, either due to TTR (ATTRwt) or ANP (IAA) appears to play an important role in both diseases and in their interaction. In terms of diagnostics, bone scintigraphy has become available and affords an easy and reliable way to establish the presence of cardiac ATTRwt. Moreover, pharmacological options are now available or under development to treat ATTRwt and possibly also IAA, thereby potentially stopping, or even reversing, the downhill course of some patients with HFpEF and AF.