{"id":3588,"date":"2021-04-14T12:30:55","date_gmt":"2021-04-14T12:30:55","guid":{"rendered":"https:\/\/www.reseau-amylose.org\/jesuissoignant\/?page_id=3588"},"modified":"2026-08-25T20:01:21","modified_gmt":"2026-08-25T18:01:21","slug":"les-traitements-cardiologiques-des-atteintes-cardiaques-des-amyloses","status":"publish","type":"page","link":"https:\/\/reseau-amylose.org\/jesuissoignant\/les-traitements-cardiologiques-des-atteintes-cardiaques-des-amyloses\/","title":{"rendered":"Les traitements cardiologiques"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"3588\" class=\"elementor elementor-3588\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3c4b987 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3c4b987\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-848195c\" data-id=\"848195c\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a96422a elementor-widget elementor-widget-heading\" data-id=\"a96422a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Les traitements cardiologiques<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-24281eee elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"24281eee\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6dc57127 elementor-widget elementor-widget-heading\" data-id=\"6dc57127\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h6 class=\"elementor-heading-title elementor-size-default\"><h2 class=\"elementor-heading-title elementor-size-large elementor-inline-editing pen\" data-elementor-setting-key=\"title\" data-pen-placeholder=\"\u00c9crivez ici...\">Les traitements de l'amylose<\/h2><\/h6>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5c71ece elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5c71ece\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-432a76d\" data-id=\"432a76d\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-374a16f elementor-widget elementor-widget-text-editor\" data-id=\"374a16f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><em>Le d\u00e9bit cardiaque des c\u0153urs amylo\u00efdes d\u00e9pend directement de la fr\u00e9quence cardiaque, du fait de la rigidit\u00e9 pari\u00e9tale li\u00e9e \u00e0 l&rsquo;infiltration. Cela conditionne toute la prise en charge : diur\u00e9tiques en premi\u00e8re ligne, b\u00e9tabloquants et bradycardisants contre-indiqu\u00e9s, anticoagulation \u00e0 discuter syst\u00e9matiquement, et indications larges de pacemaker.<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-d981eff elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"d981eff\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-b4ed53a\" data-id=\"b4ed53a\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-b3204c3 elementor-widget elementor-widget-heading\" data-id=\"b3204c3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Points cl\u00e9s pour les professionnels de sant\u00e9<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fdcb1b5 elementor-widget elementor-widget-text-editor\" data-id=\"fdcb1b5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li>Le d\u00e9bit cardiaque est directement d\u00e9pendant de la fr\u00e9quence cardiaque (FC cible 70-120 bpm) : b\u00e9tabloquants, inhibiteurs calciques bradycardisants et ivabradine sont contre-indiqu\u00e9s.<\/li><li>Les diur\u00e9tiques restent le pilier du traitement symptomatique, avec une \u00e9valuation vol\u00e9mique clinique, biologique et \u00e9chographique.<\/li><li>Le sacubitril-valsartan est plut\u00f4t contre-indiqu\u00e9 (inhibition possible de la d\u00e9gradation des fibrilles amylo\u00efdes) et les IEC\/ARA2 n&rsquo;ont pas de preuve d&rsquo;efficacit\u00e9.<\/li><li>La FA touche jusqu&rsquo;\u00e0 70 % des patients au cours du suivi ; l&rsquo;anticoagulation efficace est recommand\u00e9e quel que soit le score CHA2DS2-VASc en cas de trouble du rythme auriculaire av\u00e9r\u00e9.<\/li><li>L&rsquo;amiodarone est l&rsquo;antiarythmique de premi\u00e8re intention ; les indications de pacemaker doivent \u00eatre larges et anticip\u00e9es.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-26aea998 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"26aea998\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5ccf7227\" data-id=\"5ccf7227\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-97200b2 elementor-widget elementor-widget-heading\" data-id=\"97200b2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Physiopathologie des amyloses cardiaques<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-411f534d elementor-widget elementor-widget-text-editor\" data-id=\"411f534d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><strong>Physiopathologie de l&rsquo;infiltration : <\/strong><\/h3><p>Les prot\u00e9ines amylo\u00efdes infiltrent de mani\u00e8re diffuse les structures cardiaques. L&rsquo;infiltration des parois ventriculaires est responsable d&rsquo;une cardiomyopathie hypertrophique et restrictive, causant une insuffisance cardiaque \u00e0 FEVG le plus souvent pr\u00e9serv\u00e9e mais avec une physiopathologie tr\u00e8s particuli\u00e8re. Des troubles rythmiques ventriculaires peuvent \u00eatre observ\u00e9s, notamment dans les amyloses AL. L&rsquo;infiltration de la paroi des oreillettes est \u00e0 l&rsquo;origine de troubles du rythme auriculaire et d&rsquo;un d\u00e9faut de contractilit\u00e9 auriculaire, source de complications thrombo-emboliques. L&rsquo;infiltration des faisceaux \u00e9lectriques est \u00e0 l&rsquo;origine de troubles conductifs. Ce ph\u00e9nom\u00e8ne dynamique cause des complications \u00e9volutives ; un diagnostic et une prise en charge pr\u00e9coces permettent de les pr\u00e9venir et d&rsquo;am\u00e9liorer la morbi-mortalit\u00e9 des patients.<\/p><h3><strong>D\u00e9pendance \u00e0 la fr\u00e9quence cardiaque : <\/strong><\/h3><p>L&rsquo;amylose cardiaque est une cardiomyopathie hypertrophique et restrictive, caract\u00e9ris\u00e9e par une alt\u00e9ration majeure de la compliance ventriculaire entra\u00eenant une absence de r\u00e9serve de pr\u00e9charge et une diminution du volume d&rsquo;\u00e9jection systolique. Le d\u00e9bit cardiaque \u00e9tant le produit de la fr\u00e9quence cardiaque par le volume d&rsquo;\u00e9jection systolique, il est directement d\u00e9pendant de la fr\u00e9quence cardiaque. Toute r\u00e9duction de celle-ci \u2014 troubles conductifs, insuffisance chronotrope, traitement bradycardisant \u2014 entra\u00eene une baisse du d\u00e9bit cardiaque, d\u00e9l\u00e9t\u00e8re et mal tol\u00e9r\u00e9e.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5aac151 elementor-widget elementor-widget-image\" data-id=\"5aac151\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"1024\" height=\"518\" src=\"https:\/\/reseau-amylose.org\/jesuissoignant\/wp-content\/uploads\/sites\/5\/2021\/04\/Capture-de\u0301cran-2021-04-15-a\u0300-13.46.35-1024x518.png\" class=\"attachment-large size-large wp-image-3662\" alt=\"\" srcset=\"https:\/\/reseau-amylose.org\/jesuissoignant\/wp-content\/uploads\/sites\/5\/2021\/04\/Capture-de\u0301cran-2021-04-15-a\u0300-13.46.35-1024x518.png 1024w, https:\/\/reseau-amylose.org\/jesuissoignant\/wp-content\/uploads\/sites\/5\/2021\/04\/Capture-de\u0301cran-2021-04-15-a\u0300-13.46.35-300x152.png 300w, https:\/\/reseau-amylose.org\/jesuissoignant\/wp-content\/uploads\/sites\/5\/2021\/04\/Capture-de\u0301cran-2021-04-15-a\u0300-13.46.35-768x388.png 768w, https:\/\/reseau-amylose.org\/jesuissoignant\/wp-content\/uploads\/sites\/5\/2021\/04\/Capture-de\u0301cran-2021-04-15-a\u0300-13.46.35-1536x777.png 1536w, https:\/\/reseau-amylose.org\/jesuissoignant\/wp-content\/uploads\/sites\/5\/2021\/04\/Capture-de\u0301cran-2021-04-15-a\u0300-13.46.35-1568x793.png 1568w, https:\/\/reseau-amylose.org\/jesuissoignant\/wp-content\/uploads\/sites\/5\/2021\/04\/Capture-de\u0301cran-2021-04-15-a\u0300-13.46.35.png 1732w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c00cdd8 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c00cdd8\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-39d2249\" data-id=\"39d2249\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1326262 elementor-widget elementor-widget-heading\" data-id=\"1326262\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Traitement m\u00e9dical de l'insuffisance cardiaque<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e69a2c3 elementor-widget elementor-widget-text-editor\" data-id=\"e69a2c3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><strong>Traitements sp\u00e9cifiques indiqu\u00e9s : <\/strong><\/h3><p>Les amyloses AL et ATTR disposent de traitements sp\u00e9cifiques, seuls capables de stopper ou de ralentir la maladie (voir la page Traitement sp\u00e9cifique).<\/p><h3><strong>Traitements indiqu\u00e9s ou conseill\u00e9s<\/strong><\/h3><p>Les diur\u00e9tiques ont une place essentielle dans le traitement symptomatique pour contr\u00f4ler les signes congestifs. De fortes doses de diur\u00e9tiques de l&rsquo;anse sont souvent n\u00e9cessaires ; un autre diur\u00e9tique (thiazidique ou spironolactone) peut \u00eatre associ\u00e9. Une restriction hydro-sod\u00e9e doit \u00eatre recommand\u00e9e en cas d&rsquo;hyponatr\u00e9mie.<\/p><p>L&rsquo;\u00e9valuation de la vol\u00e9mie pour ajuster la dose de diur\u00e9tiques est une \u00e9tape importante de la consultation, parfois difficile en cas d&rsquo;amylose cardiaque : il faut s&rsquo;appuyer sur un faisceau d&rsquo;arguments cliniques, biologiques et \u00e9chographiques. Une surveillance par t\u00e9l\u00e9-cardiologie peut avoir un int\u00e9r\u00eat dans le suivi.<\/p><p><strong>FC cible : 70-120 bpm<\/strong><\/p><h3><strong>Traitements non indiqu\u00e9s ou d\u00e9conseill\u00e9s<\/strong><\/h3><table width=\"623\"><tbody><tr><td width=\"187\"><p><strong>Traitement<\/strong><\/p><\/td><td width=\"437\"><p><strong>Statut et raison<\/strong><\/p><\/td><\/tr><tr><td width=\"187\"><p>B\u00e9tabloquants<\/p><\/td><td width=\"437\"><p>Contre-indiqu\u00e9s (sauf rares situations apr\u00e8s avis expert : obstruction intra-ventriculaire gauche symptomatique, FA tr\u00e8s rapide mal tol\u00e9r\u00e9e)<\/p><\/td><\/tr><tr><td width=\"187\"><p>Inhibiteurs calciques bradycardisants<\/p><\/td><td width=\"437\"><p>Contre-indiqu\u00e9s (m\u00eame raison que les b\u00e9tabloquants)<\/p><\/td><\/tr><tr><td width=\"187\"><p>Ivabradine<\/p><\/td><td width=\"437\"><p>Contre-indiqu\u00e9e (m\u00eame raison)<\/p><\/td><\/tr><tr><td width=\"187\"><p>Digoxine<\/p><\/td><td width=\"437\"><p>Historiquement contre-indiqu\u00e9e (liaison avec les fibrilles amylo\u00efdes) ; utilisation pr\u00e9cautionneuse possible (risque rythmique)<\/p><\/td><\/tr><tr><td width=\"187\"><p>IEC-ARA2<\/p><\/td><td width=\"437\"><p>Pas de preuve d&rsquo;efficacit\u00e9 sur la cardiopathie amylo\u00efde, risque d&rsquo;hypotension art\u00e9rielle ; r\u00e9\u00e9valuer l&rsquo;indication initiale si autre pathologie associ\u00e9e<\/p><\/td><\/tr><tr><td width=\"187\"><p>Sacubitril-Valsartan<\/p><\/td><td width=\"437\"><p>Plut\u00f4t contre-indiqu\u00e9 (le sacubitril pourrait inhiber la d\u00e9gradation des fibrilles amylo\u00efdes) et pas de preuve d&rsquo;efficacit\u00e9 (\u00e9tude PARAGON-HF)<\/p><\/td><\/tr><\/tbody><\/table><p>\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9367ea6 elementor-widget elementor-widget-heading\" data-id=\"9367ea6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Anticoagulant et FA\/Flutter<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-69a351f elementor-widget elementor-widget-text-editor\" data-id=\"69a351f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><strong>Indication : <\/strong><\/h3><p>L&rsquo;amylose cardiaque est une pathologie \u00e0 haut risque thrombog\u00e8ne. Une fibrillation auriculaire est fr\u00e9quemment observ\u00e9e au cours du suivi (jusqu&rsquo;\u00e0 70 % des cas), quel que soit le type d&rsquo;amylose, et sa pr\u00e9valence augmente avec l&rsquo;\u00e9volutivit\u00e9 de la maladie. Elle expose \u00e0 des complications thrombo-emboliques, les thrombus pouvant \u00eatre observ\u00e9s de mani\u00e8re diffuse dans les deux oreillettes m\u00eame sous anticoagulation efficace. Des thrombus intracardiaques peuvent aussi \u00eatre observ\u00e9s en rythme sinusal en cas d&rsquo;alt\u00e9ration s\u00e9v\u00e8re de la contractilit\u00e9 auriculaire, notamment dans les amyloses AL.<\/p><h3><strong>B\u00e9n\u00e9fice-risque : <\/strong><\/h3><p>Une anticoagulation efficace est recommand\u00e9e en cas de trouble du rythme auriculaire av\u00e9r\u00e9, quel que soit le score CHA2DS2-VASc. AVK et AOD peuvent \u00eatre utilis\u00e9s avec une efficacit\u00e9 et une s\u00e9curit\u00e9 comparables. Une anticoagulation peut \u00eatre discut\u00e9e au cas par cas chez les patients en rythme sinusal \u00e0 risque thrombog\u00e8ne jug\u00e9 \u00e9lev\u00e9 (infiltration auriculaire marqu\u00e9e \u00e0 l&rsquo;IRM, perte de contractilit\u00e9 auriculaire en ETT, ant\u00e9c\u00e9dents emboliques suspects). Le risque h\u00e9morragique doit \u00eatre \u00e9valu\u00e9 pour chaque patient, notamment en cas d&rsquo;amylose AL sous chimioth\u00e9rapie.<\/p><h3><strong>FA et flutter : <\/strong><\/h3><p>Si la pr\u00e9sence d&rsquo;une arythmie auriculaire n&rsquo;est pas associ\u00e9e \u00e0 une surmortalit\u00e9, les hospitalisations pour d\u00e9compensation cardiaque sont plus fr\u00e9quentes, la perte de la contraction auriculaire \u00e9tant d\u00e9l\u00e9t\u00e8re pour le d\u00e9bit cardiaque. Des fr\u00e9quences cardiaques plus \u00e9lev\u00e9es sont g\u00e9n\u00e9ralement mieux tol\u00e9r\u00e9es. Le traitement repose sur une anticoagulation curative et l&rsquo;amiodarone est recommand\u00e9e en premi\u00e8re intention pour r\u00e9duire ou ralentir une FA rapide symptomatique. Une FA lente peut justifier l&rsquo;implantation d&rsquo;un pacemaker ; une FA rapide mal tol\u00e9r\u00e9e peut justifier un avis d&rsquo;expert (minime dose de b\u00e9tabloquant, ablation du n\u0153ud atrio-ventriculaire).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-0a5085d elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"0a5085d\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-ed9b2ed\" data-id=\"ed9b2ed\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-aaffdcd elementor-widget elementor-widget-text-editor\" data-id=\"aaffdcd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>\u00a0\u00a0<\/p><p>\u00a0<\/p><p>\u00a0<\/p><p>\u00a0\u00a0<\/p><p>\u00a0\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a7b7b91 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"a7b7b91\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-md\" href=\"https:\/\/www.reseau-amylose.org\/jesuissoignant\/documentation\/triptyques\/\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">T\u00e9l\u00e9chargez le triptyque  \"Prise en charge cardiologique des amyloses cardiaques\"<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d4ba2d5 elementor-widget elementor-widget-text-editor\" data-id=\"d4ba2d5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\" style=\"text-align: center\"><em>Document r\u00e9dige\u0301 par Dr Lisa GREEN et relu par Dr Gagan DEEP SINGH CHADHA<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-a3c3e08\" data-id=\"a3c3e08\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ad20906 elementor-widget elementor-widget-text-editor\" data-id=\"ad20906\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong><span style=\"color: #4db8f0\">Comment adapter le traitement cardiologique ?\u00a0<\/span><\/strong><\/p><p><em><span style=\"color: #4db8f0\">Dr Lisa GREEN<\/span><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4b84647 elementor-widget elementor-widget-video\" data-id=\"4b84647\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;youtube_url&quot;:&quot;https:\\\/\\\/www.youtube.com\\\/watch?v=XxmihIi-rns&amp;list=PLgcbJqP0xnzjk0ZXZFG83enHJBWuFAdjq&amp;index=4&amp;ab_channel=R%C3%A9seauAmyloseR%C3%A9seauAmylose&quot;,&quot;video_type&quot;:&quot;youtube&quot;,&quot;controls&quot;:&quot;yes&quot;}\" data-widget_type=\"video.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-wrapper elementor-open-inline\">\n\t\t\t<div class=\"elementor-video\"><\/div>\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5a8a68b elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5a8a68b\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-8003a21\" data-id=\"8003a21\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-351409d elementor-widget elementor-widget-heading\" data-id=\"351409d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Prise en charge rythmologique<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-79d1b11 elementor-widget elementor-widget-text-editor\" data-id=\"79d1b11\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><strong>Cardioversion \u00e9lectrique : <\/strong><\/h3><p>Il peut \u00eatre raisonnable de tenter la restauration du rythme sinusal en cas de FA de novo ou pr\u00e9cocement dans l&rsquo;\u00e9volutivit\u00e9 de la maladie. Une ETO avant cardioversion est recommand\u00e9e pour s&rsquo;assurer de l&rsquo;absence de thrombus intracardiaque, malgr\u00e9 une anticoagulation efficace. Des complications rythmiques sont plus fr\u00e9quentes apr\u00e8s cardioversion : attention au risque de bradycardie\/dysfonction sinusale, pouvant justifier une implantation de pacemaker pr\u00e9ventive.<\/p><h3><strong>Ablation flutter\/FA : <\/strong><\/h3><p>Une restauration du rythme sinusal par strat\u00e9gie ablative peut \u00eatre discut\u00e9e avec un centre expert. Les r\u00e9sultats sont moins bons que dans la FA classique, avec un risque de r\u00e9currence plus \u00e9lev\u00e9 ; ils semblent meilleurs dans les formes pr\u00e9coces de la maladie (infiltration moindre des oreillettes).<\/p><p><strong>Pacemaker (PM) : <\/strong>l&rsquo;infiltration des faisceaux \u00e9lectriques par les d\u00e9p\u00f4ts amylo\u00efdes entra\u00eene des troubles conductifs \u00e9volutifs, pouvant \u00eatre mal tol\u00e9r\u00e9s avec un risque de choc cardiog\u00e9nique en cas de BAV de haut degr\u00e9 (bradycardie et perte de la systole atriale). Un suivi r\u00e9gulier par ECG et Holter-ECG est recommand\u00e9, avec explorations invasives au cas par cas. Il est raisonnable de pr\u00e9venir ces troubles conductifs en implantant un pacemaker plus pr\u00e9cocement que ce qui est recommand\u00e9 de fa\u00e7on g\u00e9n\u00e9rale.<\/p><h3><strong>CRT (resynchronisation) : <\/strong><\/h3><p>Une th\u00e9rapie de resynchronisation ventriculaire peut \u00eatre propos\u00e9e au cas par cas en cas de FEVG &lt; 35 % apr\u00e8s avis expert.<\/p><h3><strong>DAI (d\u00e9fibrillateur) : <\/strong><\/h3><p>Des troubles du rythme ventriculaire peuvent \u00eatre observ\u00e9s quel que soit le type d&rsquo;amylose (AL &gt; ATTR h\u00e9r\u00e9ditaire &gt; ATTR sauvage). L&rsquo;implantation d&rsquo;un DAI peut \u00eatre propos\u00e9e en pr\u00e9vention secondaire, ou en pr\u00e9vention primaire si la FEVG est &lt; 35 %, \u00e0 discuter au cas par cas apr\u00e8s avis expert en cas de crit\u00e8res de gravit\u00e9 (strain tr\u00e8s alt\u00e9r\u00e9, amylose AL stade IIIA).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4de4fcda elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4de4fcda\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-e03639f\" data-id=\"e03639f\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3b040082 elementor-widget elementor-widget-text-editor\" data-id=\"3b040082\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong><span style=\"color: #4db8f0\">Quels traitements de l&rsquo;insuffisance cardiaque prescrire dans l&rsquo;amylose cardiaque<\/span><\/strong><\/p><p><em><span style=\"color: #4db8f0\">Dr Damien LOGEART<\/span><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2875630e elementor-widget elementor-widget-video\" data-id=\"2875630e\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;youtube_url&quot;:&quot;https:\\\/\\\/www.youtube.com\\\/watch?v=yqChnE3Jjio&amp;ab_channel=R%C3%A9seauAmylose&quot;,&quot;video_type&quot;:&quot;youtube&quot;,&quot;controls&quot;:&quot;yes&quot;}\" data-widget_type=\"video.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-wrapper elementor-open-inline\">\n\t\t\t<div class=\"elementor-video\"><\/div>\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-1ee6e072\" data-id=\"1ee6e072\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-54d7f4f elementor-widget elementor-widget-text-editor\" data-id=\"54d7f4f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong><span style=\"color: #4db8f0\">Pourquoi les b\u00e9tabloquants sont contre indiqu\u00e9s dans l&rsquo;amylose ?\u00a0<\/span><\/strong><\/p><p><em><span style=\"color: #4db8f0\">Dr Silvia OGHINA<\/span><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-69a8ae8e elementor-widget elementor-widget-video\" data-id=\"69a8ae8e\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;youtube_url&quot;:&quot;https:\\\/\\\/www.youtube.com\\\/watch?v=KiuQ0wjJwTs&amp;ab_channel=R%C3%A9seauAmylose&quot;,&quot;video_type&quot;:&quot;youtube&quot;,&quot;controls&quot;:&quot;yes&quot;}\" data-widget_type=\"video.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-wrapper elementor-open-inline\">\n\t\t\t<div class=\"elementor-video\"><\/div>\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-5470c425\" data-id=\"5470c425\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6337611b elementor-widget elementor-widget-text-editor\" data-id=\"6337611b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong><span style=\"color: #4db8f0\">Trouble du rythme ventriculaire et amylose cardiaque : d\u00e9pistage, traitement<\/span><\/strong><\/p><p><em><span style=\"color: #4db8f0\">Dr Guillaume ABESHIRA<\/span><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-68e7fd12 elementor-widget elementor-widget-video\" data-id=\"68e7fd12\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;youtube_url&quot;:&quot;https:\\\/\\\/www.youtube.com\\\/watch?v=AGxjzPXJkFM&amp;ab_channel=R%C3%A9seauAmylose&quot;,&quot;video_type&quot;:&quot;youtube&quot;,&quot;controls&quot;:&quot;yes&quot;}\" data-widget_type=\"video.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-wrapper elementor-open-inline\">\n\t\t\t<div class=\"elementor-video\"><\/div>\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-438f67d2 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"438f67d2\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-5cf6e3d2\" data-id=\"5cf6e3d2\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6d0f6801 elementor-widget elementor-widget-text-editor\" data-id=\"6d0f6801\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong><span style=\"color: #4db8f0\">Prise en charge cardiologique et rythmologique des amyloses<\/span><\/strong><\/p><p><em><span style=\"color: #4db8f0\">Pr Thibaud DAMY &amp; Dr Vincent ALGALARRONDO<\/span><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7d6f9d06 elementor-widget elementor-widget-video\" data-id=\"7d6f9d06\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;youtube_url&quot;:&quot;https:\\\/\\\/www.youtube.com\\\/watch?v=SwJFBUJiJpE&amp;ab_channel=R%C3%A9seauAmylose&quot;,&quot;video_type&quot;:&quot;youtube&quot;,&quot;controls&quot;:&quot;yes&quot;}\" data-widget_type=\"video.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-wrapper elementor-open-inline\">\n\t\t\t<div class=\"elementor-video\"><\/div>\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-361890a4\" data-id=\"361890a4\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-63c45938 elementor-widget elementor-widget-text-editor\" data-id=\"63c45938\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong><span style=\"color: #4db8f0\">Insuffisance chronotrope et amylose : d\u00e9pistage et traitement<\/span><\/strong><\/p><p><em><span style=\"color: #4db8f0\">Dr Astrid MONFORT<\/span><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3d320308 elementor-widget elementor-widget-video\" data-id=\"3d320308\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;youtube_url&quot;:&quot;https:\\\/\\\/www.youtube.com\\\/watch?v=MJwz_sLCIj8&amp;ab_channel=R%C3%A9seauAmylose&quot;,&quot;video_type&quot;:&quot;youtube&quot;,&quot;controls&quot;:&quot;yes&quot;}\" data-widget_type=\"video.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-wrapper elementor-open-inline\">\n\t\t\t<div class=\"elementor-video\"><\/div>\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-354fb0fa\" data-id=\"354fb0fa\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-50c23688 elementor-widget elementor-widget-text-editor\" data-id=\"50c23688\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong><span style=\"color: #4db8f0\">Les troubles de la conduction dans l&rsquo;amylose cardiaque<\/span><\/strong><\/p><p><em><span style=\"color: #4db8f0\">Pr Olivier LAIREZ<\/span><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-649573ac elementor-widget elementor-widget-video\" data-id=\"649573ac\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;youtube_url&quot;:&quot;https:\\\/\\\/www.youtube.com\\\/watch?v=jk7aMiQZqBs&amp;ab_channel=R%C3%A9seauAmylose&quot;,&quot;video_type&quot;:&quot;youtube&quot;,&quot;controls&quot;:&quot;yes&quot;}\" data-widget_type=\"video.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-wrapper elementor-open-inline\">\n\t\t\t<div class=\"elementor-video\"><\/div>\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-497c127e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"497c127e\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-656fe60c\" data-id=\"656fe60c\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-68d4d65f elementor-widget elementor-widget-text-editor\" data-id=\"68d4d65f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong><span style=\"color: #4db8f0\">Risque thrombotique dans l&rsquo;amylose : Pr\u00e9vention et traitement<\/span><\/strong><\/p><p><em><span style=\"color: #4db8f0\">Dr Martin NICOL<\/span><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b74f537 elementor-widget elementor-widget-video\" data-id=\"b74f537\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;youtube_url&quot;:&quot;https:\\\/\\\/www.youtube.com\\\/watch?v=-wZoaGi7v-I&amp;ab_channel=R%C3%A9seauAmylose&quot;,&quot;video_type&quot;:&quot;youtube&quot;,&quot;controls&quot;:&quot;yes&quot;}\" data-widget_type=\"video.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-wrapper elementor-open-inline\">\n\t\t\t<div class=\"elementor-video\"><\/div>\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-53355733\" data-id=\"53355733\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-71d9e7e7 elementor-widget elementor-widget-text-editor\" data-id=\"71d9e7e7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong><span style=\"color: #4db8f0\">Transplantation cardiaque dans l&rsquo;amylose &#8211; Quel b\u00e9n\u00e9fice ?\u00a0<\/span><\/strong><\/p><p><em><span style=\"color: #4db8f0\">Dr Soulef GUENDOUZ<\/span><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-26958853 elementor-widget elementor-widget-video\" data-id=\"26958853\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;youtube_url&quot;:&quot;https:\\\/\\\/www.youtube.com\\\/watch?v=SvfMPorwKmw&amp;ab_channel=R%C3%A9seauAmylose&quot;,&quot;video_type&quot;:&quot;youtube&quot;,&quot;controls&quot;:&quot;yes&quot;}\" data-widget_type=\"video.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-wrapper elementor-open-inline\">\n\t\t\t<div class=\"elementor-video\"><\/div>\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-1454aa81\" data-id=\"1454aa81\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6caca057 elementor-widget elementor-widget-text-editor\" data-id=\"6caca057\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong><span style=\"color: #4db8f0\">La transplantation cardiaque dans l&rsquo;amylose. Pour qui ?\u00a0<\/span><\/strong><\/p><p><em><span style=\"color: #4db8f0\">Dr Shadia VARNOUS<\/span><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-577e02c4 elementor-widget elementor-widget-video\" data-id=\"577e02c4\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;youtube_url&quot;:&quot;https:\\\/\\\/www.youtube.com\\\/watch?v=oEHj9YVqwLQ&amp;ab_channel=R%C3%A9seauAmylose&quot;,&quot;video_type&quot;:&quot;youtube&quot;,&quot;controls&quot;:&quot;yes&quot;}\" data-widget_type=\"video.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-wrapper elementor-open-inline\">\n\t\t\t<div class=\"elementor-video\"><\/div>\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-9af1e59 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"9af1e59\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7bb0364d\" data-id=\"7bb0364d\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-8b6d7ec elementor-widget elementor-widget-heading\" data-id=\"8b6d7ec\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">La transplantation cardiaque<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6386232f elementor-widget elementor-widget-text-editor\" data-id=\"6386232f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>La transplantation cardiaque peut \u00eatre envisag\u00e9e chez les patients de moins de 65 ans, dans des \u00e9quipes multidisciplinaires sp\u00e9cialis\u00e9es et apr\u00e8s une \u00e9valuation compl\u00e8te.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-f7774a8 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"f7774a8\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-d5e526f\" data-id=\"d5e526f\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-cbd399c elementor-widget elementor-widget-heading\" data-id=\"cbd399c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">FAQ \u2014 Questions fr\u00e9quentes<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f8bb660 elementor-widget elementor-widget-toggle\" data-id=\"f8bb660\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"toggle.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-toggle\">\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-2601\" class=\"elementor-tab-title\" data-tab=\"1\" role=\"button\" aria-controls=\"elementor-tab-content-2601\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Pourquoi le d\u00e9bit cardiaque d\u00e9pend-il autant de la fr\u00e9quence cardiaque dans l'amylose ?<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-2601\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"1\" role=\"region\" aria-labelledby=\"elementor-tab-title-2601\"><p>Parce que la rigidit\u00e9 pari\u00e9tale li\u00e9e \u00e0 l&rsquo;infiltration amylo\u00efde supprime la r\u00e9serve de pr\u00e9charge et limite le volume d&rsquo;\u00e9jection systolique ; le d\u00e9bit cardiaque, produit de la FC par le volume d&rsquo;\u00e9jection, devient alors directement d\u00e9pendant de la fr\u00e9quence cardiaque.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-2602\" class=\"elementor-tab-title\" data-tab=\"2\" role=\"button\" aria-controls=\"elementor-tab-content-2602\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Faut-il anticoaguler tous les patients en fibrillation atriale ?<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-2602\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"2\" role=\"region\" aria-labelledby=\"elementor-tab-title-2602\"><p>Oui, une anticoagulation efficace est recommand\u00e9e en cas de trouble du rythme auriculaire av\u00e9r\u00e9, quel que soit le score CHA2DS2-VASc, du fait du haut risque thrombog\u00e8ne propre \u00e0 l&rsquo;amylose cardiaque.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-2603\" class=\"elementor-tab-title\" data-tab=\"3\" role=\"button\" aria-controls=\"elementor-tab-content-2603\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">Le sacubitril-valsartan est-il utilisable dans l'amylose cardiaque ?<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-2603\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"3\" role=\"region\" aria-labelledby=\"elementor-tab-title-2603\"><p>Il est plut\u00f4t contre-indiqu\u00e9 : le sacubitril pourrait inhiber la d\u00e9gradation des fibrilles amylo\u00efdes, et son efficacit\u00e9 n&rsquo;est pas d\u00e9montr\u00e9e dans cette population.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1abe3281 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1abe3281\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-464a9a61\" data-id=\"464a9a61\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-29313eb5 elementor-widget elementor-widget-text-editor\" data-id=\"29313eb5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div id=\"elementor-tab-content-1336\" class=\"elementor-tab-content elementor-clearfix elementor-active\" role=\"tabpanel\" data-tab=\"6\" aria-labelledby=\"elementor-tab-title-1336\"><h5><span style=\"color: #4db8f0\"><strong>R\u00e9f\u00e9rences<\/strong><\/span><\/h5><h5>1. <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Molecular+Mechanisms+of+Amyloidosis.+Merlini+G.+and+Bellotti+V.N+Engl+Med+2003%3B349%3A583-96\" target=\"_blank\" rel=\"noopener\">Molecular Mechanisms of Amyloidosis. Merlini G. and Bellotti V.N Engl Med 2003;349:583-96<\/a><\/h5><h5>2. <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Familial+amyloid+polyneuropathy+A+clinico-pathologic+study.+Said+G%2C+Plant%C3%A9-Bordeneuve+V.+Journal+of+the+Neurological+Sciences+284+(2009)+149%E2%80%93154.\" target=\"_blank\" rel=\"noopener\">Familial amyloid polyneuropathy A clinico-pathologic study. Said G, Plant\u00e9-Bordeneuve V. Journal of the Neurological Sciences 284 (2009) 149\u2013154.<\/a><\/h5><h5>3. <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Variant-sequence+transthyretin+(isoleucine+122)+in+late-onset+cardiac+amyloidosis+in+black+Americans.+Jacobson+DR%2C+Pastore+RD%2C+Yaghoubian+R%2C+Kane+I%2C+Gallo+G%2C+Buck+FS%2CBuxbaum+JN.+N+Engl+J+Med+1997%3B336%3A466%E2%80%93473.\" target=\"_blank\" rel=\"noopener\">Variant-sequence transthyretin (isoleucine 122) in late-onset cardiac amyloidosis in black Americans. Jacobson DR, Pastore RD, Yaghoubian R, Kane I, Gallo G, Buck FS,Buxbaum JN. N Engl J Med 1997;336:466\u2013473.<\/a><\/h5><h5>4. <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Relative+apical+sparing+of+longitudinal+strain+using+two-dimensional+speckle-tracking+echocardiography+is+both+sensitive+and+specific+for+the+diagnosis+of+cardiac+amyloidosis.+Dermot+Phelan%2C+Collier+P%2C+Popovi%C4%87+Z%2CHanna+M%2C+Plana+JC%2C+Marwick+TH%2C+Thomas+JD.++Heart+2012%3B98%3A1442-1448.\" target=\"_blank\" rel=\"noopener\">Relative apical sparing of longitudinal strain using two-dimensional speckle-tracking echocardiography is both sensitive and specific for the diagnosis of cardiac amyloidosis. Dermot Phelan, Collier P,\u00a0Popovi\u0107 Z,Hanna M,\u00a0Plana JC, Marwick TH,\u00a0Thomas JD. \u00a0Heart\u00a02012;98:1442-1448.<\/a><\/h5><h5>5. <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Non-invasive+evaluation+of+the+myocardial+substrate+of+cardiac+amyloidosis+by+gadolinium+cardiac+magnetic+resonance.+Perugini+E%2C+Rapezzi+C%2C+Piva+T%2C+Leone+O%2C+Bacchi-Reggiani+L%2C+Riva+L%2C+Salvi+F%2C+Lovato+L%2C+Branzi+A%2C+Fattori+R.+Heart.+2006+Mar%3B92(3)%3A343-9.\" target=\"_blank\" rel=\"noopener\">Non-invasive evaluation of the myocardial substrate of cardiac amyloidosis by gadolinium cardiac magnetic resonance. Perugini E,\u00a0Rapezzi C,\u00a0Piva T,\u00a0Leone O,\u00a0Bacchi-Reggiani L,\u00a0Riva L,\u00a0Salvi F,\u00a0Lovato L,\u00a0Branzi A,\u00a0Fattori R. Heart.\u00a02006 Mar;92(3):343-9.<\/a><\/h5><h5>6. <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Intracardiac+thrombosis+and+embolism+in+patients+with+cardiac+amyloidosis.+Feng+D%2C+Edwards+WD%2C+Oh+JK%2C+Chandrasekaran+K%2C+Grogan+M%2C+Martinez+MW%2C+Syed+IS%2C+Hughes+DA%2C+Lust+JA%2C+Jaffe+AS%2C+Gertz+MA%2C+Klarich+KW.+Circulation+2007%3B116%3A2420%E2%80%932426.\" target=\"_blank\" rel=\"noopener\">Intracardiac thrombosis and embolism in patients with cardiac amyloidosis. Feng D, Edwards WD, Oh JK, Chandrasekaran K, Grogan M, Martinez MW, Syed IS, Hughes DA, Lust JA, Jaffe AS, Gertz MA, Klarich KW. Circulation 2007;116:2420\u20132426.<\/a><\/h5><h5>7. <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Intracardiac+thrombosis+and+embolism+in+patients+with+cardiac+amyloidosis.+Feng+D%2C+Edwards+WD%2C+Oh+JK%2C+Chandrasekaran+K%2C+Grogan+M%2C+Martinez+MW%2C+Syed+IS%2C+Hughes+DA%2C+Lust+JA%2C+Jaffe+AS%2C+Gertz+MA%2C+Klarich+KW.+Circulation+2007%3B116%3A2420%E2%80%932426.\">Role of (99m)Tc-DPD scintigraphy in diagnosis and prognosis of hereditary transthyretin-related cardiac amyloidosis. Rapezzi C, Quarta CC, Guidalotti PL, Pettinato C, Fanti S, Leone O, Ferlini A, Longhi S, Lorenzini M, Reggiani LB, Gagliardi C, Gallo P, Villani C, Salvi F. JACC Cardiovasc Imaging. 2011 Jun;4(6):659-70. <\/a><\/h5><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-17e00596 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"17e00596\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-60ead839\" data-id=\"60ead839\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-b382913 elementor-widget elementor-widget-spacer\" data-id=\"b382913\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a147382 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a147382\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-1047855\" data-id=\"1047855\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9407170 elementor-widget elementor-widget-text-editor\" data-id=\"9407170\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>La prise en charge cardiologique de l&rsquo;amylose repose sur la d\u00e9pendance du d\u00e9bit cardiaque \u00e0 la fr\u00e9quence cardiaque : b\u00e9tabloquants, inhibiteurs calciques bradycardisants et ivabradine sont contre-indiqu\u00e9s, tandis que les diur\u00e9tiques restent le traitement symptomatique de r\u00e9f\u00e9rence, avec une FC cible de 70 \u00e0 120 bpm. Le sacubitril-valsartan est d\u00e9conseill\u00e9 et les IEC\/ARA2 n&rsquo;ont pas de preuve d&rsquo;efficacit\u00e9. La fibrillation atriale touche jusqu&rsquo;\u00e0 70 % des patients au cours du suivi et justifie une anticoagulation efficace quel que soit le score CHA2DS2-VASc, en raison du haut risque thrombog\u00e8ne propre \u00e0 la maladie. La prise en charge rythmologique associe cardioversion prudente (ETO syst\u00e9matique), ablation \u00e0 discuter en centre expert, indications larges de pacemaker en pr\u00e9vention des troubles conductifs, et DAI ou CRT au cas par cas selon la s\u00e9v\u00e9rit\u00e9. La transplantation cardiaque reste une option chez les patients de moins de 65 ans s\u00e9lectionn\u00e9s.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ff8e38c elementor-widget elementor-widget-text-editor\" data-id=\"ff8e38c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li class=\"font-claude-response-body whitespace-normal break-words pl-2\"><strong>R\u00e9dig\u00e9 par<\/strong> : Contenu r\u00e9dig\u00e9 par l&rsquo;\u00e9quipe du Centre de r\u00e9f\u00e9rence des Amyloses Cardiaques<\/li><li class=\"font-claude-response-body whitespace-normal break-words pl-2\"><strong>Relu \/ valid\u00e9 par<\/strong> : Pr Thibaud DAMY, cardiologue, Coordonateur du CRAC Centre de R\u00e9f\u00e9rence des Amyloses Cardiaques APHP &#8211; CHU Henri-Mondor<\/li><li class=\"font-claude-response-body whitespace-normal break-words pl-2\"><strong>Date de derni\u00e8re mise \u00e0 jour<\/strong> 08\/2026<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Les traitements cardiologiques Les traitements de l&rsquo;amylose Le d\u00e9bit cardiaque des c\u0153urs amylo\u00efdes d\u00e9pend directement de la fr\u00e9quence cardiaque, du fait de la rigidit\u00e9 pari\u00e9tale li\u00e9e \u00e0 l&rsquo;infiltration. Cela conditionne toute la prise en charge : diur\u00e9tiques en premi\u00e8re ligne, b\u00e9tabloquants et bradycardisants contre-indiqu\u00e9s, anticoagulation \u00e0 discuter syst\u00e9matiquement, et indications larges de pacemaker. Points cl\u00e9s [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"categories":[],"tags":[],"class_list":["post-3588","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Traitement cardiologique de l&#039;amylose cardiaque - R\u00e9seau Amylose<\/title>\n<meta name=\"description\" content=\"Diur\u00e9tiques, anticoagulation, rythmologie : la prise en charge cardiologique d\u00e9taill\u00e9e de l&#039;amylose cardiaque, contre-indications incluses.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/reseau-amylose.org\/jesuissoignant\/les-traitements-cardiologiques-des-atteintes-cardiaques-des-amyloses\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Traitement cardiologique de l&#039;amylose cardiaque - 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