Nature communicationsHumansAmyloidAmyloidosisApolipoproteins ACardiomyopathies
Apolipoprotein A-IV fibrils: structural diagnosis of mixed cardiac amyloidosis.
Shintaro Aibara, Astrid Kassner, Edmond Wong, Karin Klingel, Monika Papworth, Magnus Althage, Qing-Dong Wang, Claudia Correia, Hendrik Milting, Taiana Maia de Oliveira
Published: 202510.1038/s41467-025-64902-0
Abstract
Open AccessCardiac amyloidosis (CA) occurs when misfolded proteins deposit as fibrils in the extracellular space of the heart. The fibrillogenic properties of apolipoprotein A-IV (ApoAIV) have been histologically observed and associated with CA pathogenesis. We report the structure of an ApoAIV amyloid from a patient's heart, which coexist amongst transthyretin (TTR) amyloids. These cases of undetected mixed CA highlight the importance of developing broad-spectrum anti-amyloid treatments to improve outcomes in patients.