Prem Soman, MD, PhD, FACC, FRCP
Articles by Prem Soman, MD, PhD, FACC, FRCP

A Look Into the Future of ATTR-CM Clinical Trials
ByAhmad Masri, MD, MS,Sharmila Dorbala, MD, MPH, MASNC,Omar F. Abou Ezzeddine, MD, CM, MS, FACC, FHFSA,Daniel Judge, MD, FACC, FHFSA,Prem Soman, MD, PhD, FACC, FRCP Panelists discuss how future clinical trials in transthyretin amyloid cardiomyopathy (ATTR-CM) should focus on incorporating mechanistic research, patient stratification, and diverse end points, while also including nonresponders to current therapies to better understand cardiac dysfunction and develop more personalized treatment strategies.

Prognostic Indicators of Disease Progression in ATTR-CM
ByAhmad Masri, MD, MS,Sharmila Dorbala, MD, MPH, MASNC,Omar F. Abou Ezzeddine, MD, CM, MS, FACC, FHFSA,Daniel Judge, MD, FACC, FHFSA,Prem Soman, MD, PhD, FACC, FRCP Panelists discuss how monitoring clinical indicators, cardiac imaging, biomarkers, and functional assessments—such as NT-proBNP, troponin, and the 6-minute walk test—helps detect progression in transthyretin amyloid cardiomyopathy (ATTR-CM), allowing for early intervention and optimal disease management.

Using Biomarkers to Monitor ATTR-CM
ByAhmad Masri, MD, MS,Sharmila Dorbala, MD, MPH, MASNC,Omar F. Abou Ezzeddine, MD, CM, MS, FACC, FHFSA,Daniel Judge, MD, FACC, FHFSA,Prem Soman, MD, PhD, FACC, FRCP Panelists discuss how long-term monitoring in transthyretin amyloid cardiomyopathy (ATTR-CM) involves regular clinical assessments, imaging studies, and biomarker evaluations—such as NT-proBNP, troponin, and TTR testing—to track disease progression, manage complications, and optimize patient outcomes.

Challenges to Implementing Agents
ByAhmad Masri, MD, MS,Sharmila Dorbala, MD, MPH, MASNC,Omar F. Abou Ezzeddine, MD, CM, MS, FACC, FHFSA,Daniel Judge, MD, FACC, FHFSA,Prem Soman, MD, PhD, FACC, FRCP Panelists discuss how challenges in implementing newer agents for transthyretin amyloid cardiomyopathy (ATTR-CM), such as access issues, high costs, patient adherence, and provider familiarity, can be addressed through strategies like insurance advocacy, financial assistance programs, patient education, and ongoing professional development.

Personalizing Treatment in ATTR-CM
ByAhmad Masri, MD, MS,Sharmila Dorbala, MD, MPH, MASNC,Omar F. Abou Ezzeddine, MD, CM, MS, FACC, FHFSA,Daniel Judge, MD, FACC, FHFSA,Prem Soman, MD, PhD, FACC, FRCP Panelists discuss how selecting the appropriate treatment for patients with transthyretin amyloid cardiomyopathy (ATTR-CM) involves considering factors such as disease stage, treatment goals, patient characteristics, comorbidities, and preferences, with options such as tafamidis, acoramidis, and silencer therapies offering tailored approaches to manage disease progression and improve outcomes.

The HELIOS-B Trial
ByAhmad Masri, MD, MS,Sharmila Dorbala, MD, MPH, MASNC,Omar F. Abou Ezzeddine, MD, CM, MS, FACC, FHFSA,Daniel Judge, MD, FACC, FHFSA,Prem Soman, MD, PhD, FACC, FRCP Panelists discuss how the approval of vutrisiran for transthyretin amyloid cardiomyopathy (ATTR-CM), based on positive results from the HELIOS-B trial, provides a significant therapeutic option by reducing TTR levels and improving clinical outcomes, alongside supportive findings from other key trials such as ATTR-ACT and ATTRibute-CM.

The Evolving Treatment Landscape of ATTR-CM
ByAhmad Masri, MD, MS,Sharmila Dorbala, MD, MPH, MASNC,Omar F. Abou Ezzeddine, MD, CM, MS, FACC, FHFSA,Daniel Judge, MD, FACC, FHFSA,Prem Soman, MD, PhD, FACC, FRCP Panelists discuss how the current treatment landscape for transthyretin amyloid cardiomyopathy (ATTR-CM) includes transthyretin stabilizers and silencers, with key trials such as ATTRibute-CM and ATTR-ACT showing promising results for improving cardiac function and patient outcomes.

Challenges in Treating ATTR-CM
ByAhmad Masri, MD, MS,Sharmila Dorbala, MD, MPH, MASNC,Omar F. Abou Ezzeddine, MD, CM, MS, FACC, FHFSA,Daniel Judge, MD, FACC, FHFSA,Prem Soman, MD, PhD, FACC, FRCP Panelists discuss how treating patients with transthyretin amyloid cardiomyopathy (ATTR-CM) is challenging due to delayed diagnosis, disease heterogeneity, limited treatment options, multisystem involvement, genetic counseling needs, advanced organ damage, and patient adherence issues.

Centers of ATTR-CM and Family Counseling
ByAhmad Masri, MD, MS,Sharmila Dorbala, MD, MPH, MASNC,Omar F. Abou Ezzeddine, MD, CM, MS, FACC, FHFSA,Daniel Judge, MD, FACC, FHFSA,Prem Soman, MD, PhD, FACC, FRCP Panelists discuss how referring patients with transthyretin amyloid (ATTR) to a specialty center or center of excellence ensures expert diagnosis, comprehensive care, advanced treatment options, and essential genetic counseling and family screening for improved outcomes.

Facilitating an Early Diagnosis in ATTR-CM
ByAhmad Masri, MD, MS,Sharmila Dorbala, MD, MPH, MASNC,Omar F. Abou Ezzeddine, MD, CM, MS, FACC, FHFSA,Daniel Judge, MD, FACC, FHFSA,Prem Soman, MD, PhD, FACC, FRCP Panelists discuss how early diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM) relies on clinical awareness, recognizing red flag symptoms, and utilizing tools such as bone scintigraphy (PYP scan), genetic testing, and advanced cardiac imaging, which can lead to timely interventions, improved prognosis, and better patient outcomes.

Differentiating ATTR-CM and PN
ByAhmad Masri, MD, MS,Sharmila Dorbala, MD, MPH, MASNC,Omar F. Abou Ezzeddine, MD, CM, MS, FACC, FHFSA,Daniel Judge, MD, FACC, FHFSA,Prem Soman, MD, PhD, FACC, FRCP Panelists discuss how diagnosing transthyretin amyloid cardiomyopathy (ATTR-CM) and transthyretin amyloid polyneuropathy (ATTR-PN) involves recognizing key differences in organ involvement, with ATTR-CM primarily affecting the heart and ATTR-PN impacting the nervous system, and emphasize the importance of tailored diagnostic approaches using genetic testing, imaging, and biopsies for accurate identification and treatment.

Diagnostic Approach to ATTR-CM
ByAhmad Masri, MD, MS,Sharmila Dorbala, MD, MPH, MASNC,Omar F. Abou Ezzeddine, MD, CM, MS, FACC, FHFSA,Daniel Judge, MD, FACC, FHFSA,Prem Soman, MD, PhD, FACC, FRCP Panelists discuss how early clinical suspicion, genetic testing, cardiac biomarkers, and imaging techniques are crucial for diagnosing transthyretin amyloid cardiomyopathy (ATTR-CM), while also highlighting challenges such as common misdiagnoses and delayed diagnoses, which can significantly impact patient outcomes and quality of life.

Clinical Manifestation of ATTR-CM and Red Flag Symptoms
ByAhmad Masri, MD, MS,Sharmila Dorbala, MD, MPH, MASNC,Omar F. Abou Ezzeddine, MD, CM, MS, FACC, FHFSA,Daniel Judge, MD, FACC, FHFSA,Prem Soman, MD, PhD, FACC, FRCP Panelists discuss how recognizing key clinical manifestations and red flag symptoms, such as bilateral carpal tunnel syndrome, spinal stenosis, and trigger fingers, is critical for early diagnosis and intervention in patients with transthyretin amyloid cardiomyopathy (ATTR-CM), particularly in those with unexplained heart failure or arrhythmias.

Common TTR Gene Mutations
ByAhmad Masri, MD, MS,Sharmila Dorbala, MD, MPH, MASNC,Omar F. Abou Ezzeddine, MD, CM, MS, FACC, FHFSA,Daniel Judge, MD, FACC, FHFSA,Prem Soman, MD, PhD, FACC, FRCP Panelists discuss how identifying the most common TTR gene mutations, including V30M, T60A, and V122I, is essential for accurate diagnosis, understanding clinical presentations, and tailoring treatment strategies for hereditary transthyretin amyloidosis in the United States.

The Pathophysiology of ATTR-CM, Differentiating Between wtATTR-CM and hATTR-CM
ByAhmad Masri, MD, MS,Sharmila Dorbala, MD, MPH, MASNC,Omar F. Abou Ezzeddine, MD, CM, MS, FACC, FHFSA,Daniel Judge, MD, FACC, FHFSA,Prem Soman, MD, PhD, FACC, FRCP Panelists discuss how differentiating between wild-type transthyretin amyloid cardiomyopathy (wATTR-CM) and hereditary transthyretin amyloid cardiomyopathy (hATTR-CM) is essential for accurate diagnosis, tailored treatment strategies, and better management of patient outcomes, given their distinct pathophysiologies, disease progression, and treatment options.

Differentiating Between Light Chain and Transthyretin Amyloidosis
ByAhmad Masri, MD, MS,Sharmila Dorbala, MD, MPH, MASNC,Omar F. Abou Ezzeddine, MD, CM, MS, FACC, FHFSA,Daniel Judge, MD, FACC, FHFSA,Prem Soman, MD, PhD, FACC, FRCP Panelists discuss how differentiating between light chain amyloidosis and transthyretin amyloidosis is crucial for accurate diagnosis, appropriate treatment selection, and optimal patient management, given their distinct etiologies, therapeutic approaches, and prognoses.

Increasing Awareness Around ATTR-CM
ByAhmad Masri, MD, MS,Sharmila Dorbala, MD, MPH, MASNC,Omar F. Abou Ezzeddine, MD, CM, MS, FACC, FHFSA,Daniel Judge, MD, FACC, FHFSA,Prem Soman, MD, PhD, FACC, FRCP Panelists discuss how increasing recognition of transthyretin amyloid cardiomyopathy (ATTR-CM), fueled by advancements in diagnostic tools and greater awareness, is challenging its classification as a rare disease, particularly in aging populations, and emphasizing the need for earlier diagnosis and intervention.