Multimodality Imaging in the Evaluation and Prognostication of Cardiac Amyloidosis

Frontiers in Cardiovascular Medicine

article

Allison G. Hays¹  Joban Vaishnav¹  Paul J. Scheel, III¹  Monica Mukherjee¹ 

[1] Division of Cardiology, Johns Hopkins University School of Medicine

关键词: cardiac amyloidosis;    echocardiography;    cardiac magnetic resonance imaging (CMR);    endomyocardial biopsy;    cardiac scintigraphy;    nuclear imaging;   

DOI  :  10.3389/fcvm.2022.787618

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Cardiac amyloidosis (CA) is an infiltrative cardiomyopathy resulting from deposition of misfolded immunoglobulin light chains (AL-CA) or transthyretin (ATTR-CA) proteins in the myocardium. Survival varies between the different subtypes of amyloidosis and degree of cardiac involvement, but accurate diagnosis is essential to ensure initiation of therapeutic interventions that may slow or potentially prevent morbidity and mortality in these patients. As there are now effective treatment options for CA, identifying underlying disease pathogenesis is crucial and can be guided by multimodality imaging techniques such as echocardiography, magnetic resonance imaging, and nuclear scanning modalities. However, as use of cardiac imaging is becoming more widespread, understanding optimal applications and potential shortcomings is increasingly important. Additionally, certain imaging modalities can provide prognostic information and may affect treatment planning. In patients whom imaging remains non-diagnostic, tissue biopsy, specifically endomyocardial biopsy, continues to play an essential role and can facilitate accurate and timely diagnosis such that appropriate treatment can be started. In this review, we examine the multimodality imaging approach to the diagnosis of CA with particular emphasis on the prognostic utility and limitations of each imaging modality. We also discuss how imaging can guide the decision to pursue tissue biopsy for timely diagnosis of CA.

【 授权许可】

CC BY