Imaging modalities in cardiac amyloidosis

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology Pub Date : 2024-09-19 DOI:10.1016/j.cpcardiol.2024.102858

Zubair Bashir MD , Mahnoor Musharraf MBBS , Rabia Azam MBBS , Syed Bukhari MD

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Abstract

Cardiac amyloidosis (CA) is an infiltrative restrictive cardiomyopathy caused by the deposition of amyloid fibrils in the myocardium, presenting primarily as transthyretin cardiac amyloidosis (ATTR) and immunoglobulin light chain cardiac amyloidosis (AL). ATTR is further classified into wild-type (ATTRwt) and hereditary (ATTRv) based on transthyretin gene mutation. The disease is increasingly recognized as a significant cause of heart failure. Advances in diagnostic modalities, including electrocardiography, echocardiography, cardiac magnetic resonance imaging, and technetium pyrophosphate scintigraphy, have revolutionized the non-invasive diagnosis of CA. While ATTR can often be diagnosed with scintigraphy, AL typically requires histological confirmation. This review explores these diagnostic tools, emphasizing their role in early detection and quantification of disease burden, which are crucial for timely treatment and prognostication. This comprehensive overview aims to aid clinicians in efficiently diagnosing CA, ultimately improving patient outcomes.

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心脏淀粉样变性的成像模式。

心脏淀粉样变性（CA）是由淀粉样纤维沉积在心肌中引起的浸润性局限性心肌病，主要表现为转甲状腺素心脏淀粉样变性（ATTR）和免疫球蛋白轻链心脏淀粉样变性（AL）。根据转甲状腺素基因突变，ATTR 又可分为野生型（ATTRwt）和遗传型（ATTRv）。越来越多的人认识到这种疾病是导致心力衰竭的重要原因。包括心电图、超声心动图、心脏磁共振成像和焦磷酸锝闪烁成像在内的诊断方法的进步彻底改变了 CA 的无创诊断。ATTR 通常可通过闪烁成像诊断，而 AL 通常需要组织学证实。本综述探讨了这些诊断工具，强调了它们在早期检测和量化疾病负担方面的作用，这对及时治疗和预后至关重要。本综述旨在帮助临床医生有效诊断 CA，最终改善患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Problems in Cardiology 医学-心血管系统

CiteScore

4.80

自引率

2.40%

发文量

392

审稿时长

6 days

期刊介绍： Under the editorial leadership of noted cardiologist Dr. Hector O. Ventura, Current Problems in Cardiology provides focused, comprehensive coverage of important clinical topics in cardiology. Each monthly issues, addresses a selected clinical problem or condition, including pathophysiology, invasive and noninvasive diagnosis, drug therapy, surgical management, and rehabilitation; or explores the clinical applications of a diagnostic modality or a particular category of drugs. Critical commentary from the distinguished editorial board accompanies each monograph, providing readers with additional insights. An extensive bibliography in each issue saves hours of library research.