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Review
. 2020 Dec 26;12(12):599-614.
doi: 10.4330/wjc.v12.i12.599.

Diagnostic and prognostic value of cardiac imaging in amyloidosis

Rafael Vidal-Perez  1 , Raquel Vázquez-García  2 , Gonzalo Barge-Caballero  3 , Alberto Bouzas-Mosquera  1 , Rafaela Soler-Fernandez  4 , Jose Maria Larrañaga-Moreira  4 , Maria Generosa Crespo-Leiro  3 , Jose Manuel Vazquez-Rodriguez  4
Affiliations
Review

Diagnostic and prognostic value of cardiac imaging in amyloidosis

Rafael Vidal-Perez et al. World J Cardiol. .

Abstract

Amyloidosis is an infiltrative disease caused by extracellular protein deposition that has accumulated a lot of scientific production in recent years. Different types of amyloidosis can affect the heart. Transthyretin amyloidosis and light chain amyloidosis are the two most common types of cardiac amyloidosis. These entities have a poor prognosis, so accurate diagnostic techniques are imperative for determining an early therapeutic approach. Recent advances in cardiac imaging and diagnostic strategies show that these tools are safe and can avoid the use of invasive diagnostic techniques to histological confirmation, such as endomyocardial biopsy. We performed a review on the diagnostic and prognostic implications of different cardiac imaging techniques in cardiac amyloidosis. We mainly focus on reviewing echocardiography, cardiac magnetic resonance, computed tomography and nuclear imaging techniques and the different safety measurements that can be done with each of them.

Keywords: Cardiac imaging techniques; Echocardiography; Immunoglobulin light-chain amyloidosis; Magnetic resonance imaging; Nuclear imaging; Transthyretin cardiac amyloidosis.

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Conflict of interest statement

Conflict-of-interest statement: No potential conflicts of interest.

Figures

Figure 1
Figure 1
Algorithm for diagnostic patients with suspected cardiac amyloidosis[78]. AL: Light chain amyloidosis; ATTR: Transthyretin amyloidosis; ATTRv: Variant transthyretin amyloidosis; ATTRwt: Wild-type transthyretin amyloidosis; CA: Cardiac amyloidosis; ECG: Electrocardiogram.
Figure 2
Figure 2
Transthoracic echocardiography imaging from a patient with transthyretin amyloidosis-cardiac amyloidosis. A: Strain imaging by transthoracic echocardiography; B: Reduced mid and basal values with apical sparing.
Figure 3
Figure 3
Native T1-mapping images. Abnormally elevated values of T1 native (1120 ms) in a patient with amyloidosis-cardiac amyloidosis.
Figure 4
Figure 4
Planar scintigraphy showing intense cardiac uptake of 99mTc-labeled 3,3-diphosphono-1,2-propanodicarboxylic acid corresponding to a grade 3 in a patient diagnosed with cardiac amyloidosis-transthyretin amyloidosis.
See this image and copyright information in PMC

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