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UCSF Cardiology
Transforming medicine through innovation and collaboration.
Department of Medicine

Comprehensive Amyloid Center

The Comprehensive Amyloid Center at the University of California San Francisco provides a multidisciplinary patient-centered, state-of-the-art approach for the care of each patient. Our dedicated team is comprised of experts from various disciplines, including Hematology, Cardiology, Nephrology, Neurology, Radiology, and Pathology, among others. Our team members work closely in order to ensure exceptional care for patients with all forms of amyloidosis.

The Comprehensive Amyloid Center facilitates awareness, education and training of physicians in the field of amyloidosis. In addition, our center promotes research endeavors through institutional, national and international collaboration. Our basic research investigates the mechanisms for the development of amyloid at transcriptional and post-transcriptional levels, while our translational research strives to develop novel therapies for amyloidosis. Finally, our clinical research includes national and international trials of therapeutic agents for various types of amyloidosis.

Our center serves as a resource for the support of patients, family members, and caregivers.

Patient Profile: Peter Stremmel - The Art of Gratitude

Peter Stremmel with wife Turkey Stremmel cheering on their favorite team.

In 2008, Peter Stremmel, then 58, had a treadmill cardiac stress test showing abnormalities his doctor couldn't quite explain. However, Mr. Stremmel – who runs a contemporary art gallery in Reno, NV with his wife, Turkey – felt fine, so his doctor continued to monitor him.

A few years later, Mr. Stremmel began to feel short of breath. After more tests, both in Reno and Sacramento, he was diagnosed as having hypertrophic cardiomyopathy. He was treated for this condition, but his symptoms worsened steadily.

"It was alarming enough that I said, ‘I want to get this properly checked out,' said Mr. Stremmel. A close friend suggested that he see Dr. William Grossman, the Charles and Helen Schwab Endowed Chair in Preventive Cardiology. Mr. Stremmel came to UCSF and received several examinations and more tests from Dr. Grossman, who suspected that he did not have hypertrophic cardiomyopathy.

Dr. Grossman sent him to Dr. Liviu Klein, a heart failure specialist at UCSF, for a heart catheterization and biopsy. The biopsy showed that Mr. Stremmel had cardiac amyloidosis, in which a protein called amyloid is deposited within the heart muscle, causing progressive heart failure. Of Dr. Klein, Mr. Stremmel said, "He is a real sweetheart, and explained that the type of amyloidosis I had was sometimes very slow-moving," recalled Mr. Stremmel.

Over time, however, Mr. Stremmel noticed increased shortness of breath when climbing stairs. Dr. Grossman asked him to come in for an appointment. "His bedside manner was so good," said Mr. Stremmel. "He said, ‘Pete, the condition is progressing faster than we had hoped. I think you definitely need a heart transplant.' I had been mentally preparing myself for this, and said, ‘Why didn't you tell me this over the phone?' Dr. Grossman said, ‘This isn't the kind of news I want to give over the phone.'"

When his condition continued to worsen, Mr. Stremmel entered the UCSF Medical Center ICU in March 2014, and spent the next two-and-a-half months there awaiting a new heart. Dr. Klein increased his medications and prescribed a permanent IV infusion to help support heart function. By Mr. Stremmel's side were his wife and daughter, Piper, who left her job in China to support him; his brother, Steve, also visited frequently.

"The ICU nurses are incredibly amazing, and [cardiac transplant surgeon] Dr. [Georg] Wieselthaler came to see me four or five times a week," said Mr. Stremmel. "This guy is beyond wonderful – one of the most remarkable people I've ever met. He kept telling me, ‘You're going to do fine.'" As the weeks wore on, Dr. Wieselthaler told Mr. Stremmel, "Don't get frustrated or discouraged. Your heart is coming – just be patient."

On Mother's Day, Dr. Wieselthaler told him, "We have a heart!" The surgery started at 2 a.m. and took about six hours. Mr. Stremmel spent another month recovering in the hospital, and an additional month in San Francisco coming in almost daily for tests. Dr. Teresa De Marco, leader of the Advanced Heart Failure and Heart Transplantation Program, carefully oversaw his post-transplant care and continues to monitor him closely. "She is off the charts – always very positive and encouraging," said Mr. Stremmel.

He is back to his active lifestyle, lifting weights with a trainer three times a week, riding his bike, and walking a mile-long path around the lake near his office every day. He returned to work the day after getting back to Reno. This summer he will resume his role as auctioneer at the prestigious Coeur d'Alene Art Auction, an event he co-founded more than 25 years ago and which is the nation's biggest and most successful auction of art of the American West.

His family's support and his own positive attitude helped Mr. Stremmel do so well. "I knew I would not only survive this, but excel," he said. "I felt good knowing that I had the very best doctors in the world, and I couldn't be more thankful."