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Anderson-Fabry cardiomyopathy: prevalence, pathophysiology, diagnosis and treatment.
[fabry disease]
Anderson-
Fabry
disease
(
AFD
)
is
a
lysosomal
storage
disease
caused
by
the
inappropriate
accumulation
of
globotriaosylceramide
in
tissues
due
to
a
deficiency
in
the
enzyme
α-galactosidase
A
(
α-
Gal
A
)
.
Anderson
-
Fabry
cardiomyopathy
is
characterized
by
structural
,
valvular
,
vascular
and
conduction
abnormalities
,
and
is
now
the
most
common
cause
of
mortality
in
patients
with
AFD
.
Large
-scale
metabolic
and
genetic
screening
studies
have
revealed
AFD
to
be
prevalent
in
populations
of
diverse
ethnic
origins
,
and
the
variant
form
of
AFD
represents
an
unrecognized
health
burden
.
Anderson-
Fabry
disease
is
an
X-
linked
disorder
,
and
genetic
testing
is
critical
for
the
diagnosis
of
AFD
in
women
.
Echocardiography
with
strain
imaging
and
cardiac
magnetic
resonance
imaging
using
late
enhancement
and
T
1
mapping
are
important
imaging
tools
.
The
current
therapy
for
AFD
is
enzyme
replacement
therapy
(
ERT
)
,
which
can
reverse
or
prevent
AFD
progression
,
while
gene
therapy
and
the
use
of
molecular
Â
chaperones
represent
promising
novel
therapies
for
AFD
.
Anderson
-
Fabry
cardiomyopathy
is
an
important
and
potentially
reversible
cause
of
heart
failure
that
involves
LVH
,
increased
susceptibility
to
arrhythmias
and
valvular
regurgitation
.
Genetic
testing
and
cardiac
MRI
are
important
diagnostic
tools
,
and
AFD
cardiomyopathy
is
treatable
if
ERT
is
introduced
early
.
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fabry disease
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