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Review
. 2022 Apr 15;10(4):903.
doi: 10.3390/biomedicines10040903.

Advanced Imaging in Cardiac Amyloidosis

Dominik Waldmeier  1 , Jan Herzberg  1 , Frank-Peter Stephan  1 , Marcus Seemann  2 , Nisha Arenja  1
Affiliations
Review

Advanced Imaging in Cardiac Amyloidosis

Dominik Waldmeier et al. Biomedicines. .

Abstract

This review serves as a synopsis of multimodality imaging in cardiac amyloidosis (CA), which is a disease characterized by deposition of misfolded protein fragments in the heart. It emphasizes and summarizes the diagnostic possibilities and their prognostic values. In general, echocardiography is the first diagnostic tool in patients with an identified systemic disease or unclear left ventricular hypertrophy. Several echocardiographic parameters will raise suspicion and lead to further testing. Cardiac magnetic resonance and scintigraphy with bone avid radiotracers are crucial for diagnosis of CA and even enable a distinction between different subtypes. The subject is illuminated with established guidelines and innovative recent publications to further improve early diagnosis of cardiac amyloidosis in light of current treatment options.

Keywords: CMR; PET; cardiac amyloidosis; cardiac scintigraphy; echocardiography.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Typical findings in transthoracic echocardiography: (a) Apical four-chamber view with left ventricular hypertrophy. (b) Echocardiographic strain imaging with ‘cherry-on-top’ sign.
Figure 2
Figure 2
Typical findings in cardiovascular magnetic resonance: (a) Cine image of a four-chamber view with left ventricular hypertrophy. (b) Late gadolinium enhancement of the left and right ventricular myocardium.
Figure 3
Figure 3
Typical findings in scintigraphy and single-photon emission computed tomography: (a) Anterior view of 99Tc-hydroxymethylene diphosphonate scintigraphy with myocardial uptake Perugini Grade 3. (b) Posterior view of the same study. (c) Left and right ventricular uptake of 99mTc-hydroxymethylene diphosphonate in single-photon emission computed tomography.
See this image and copyright information in PMC

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