Trends in Diagnostic Imaging of Cardiac Amyloidosis: Emerging Knowledge and Concepts
Seitaro Oda1, Masafumi Kidoh1, Yasunori Nagayama1
1From the Departments of Diagnostic Radiology (S.O., M.K., Y.N., Y.Y.), Cardiovascular Medicine (S.T., H.U., K.T.), Molecular Laboratory Medicine (H.U.), and Neurology (M.U., T.Y., Y.A.), Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto 860-8556, Japan.
Insights
Cardiac amyloidosis (CA) is increasingly identified in heart failure patients, suggesting underdiagnosis. Early diagnosis via advanced imaging and new therapies significantly improve patient survival and prognosis.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Cardiac amyloidosis (CA) was historically considered rare.
- Advances in cardiac imaging reveal higher prevalence in heart failure patients, indicating underdiagnosis.
- CA prognosis is poor, particularly in advanced heart failure stages.
Purpose of the Study:
- To review the clinical features of cardiac amyloidosis.
- To discuss current trends in noninvasive diagnostic imaging for CA.
- To highlight the importance of early diagnosis and intervention.
Main Methods:
- Review of current literature on cardiac amyloidosis.
- Discussion of noninvasive diagnostic modalities: echocardiography, cardiac MRI, nuclear imaging.
- Analysis of clinical features and diagnostic trends.
Main Results:
- Increased identification of CA in heart failure patients suggests underestimation of its incidence.
- Noninvasive imaging modalities enable precise and early CA diagnosis.
- Therapeutic advancements have improved survival rates for CA patients.
Conclusions:
- Early diagnosis of CA through advanced imaging is crucial.
- Effective therapeutic interventions are essential for improving patient prognosis.
- The actual incidence of CA is likely higher than previously thought.
Abstract:
Cardiac amyloidosis (CA) has long been recognized as a rare disease. However, recent advances in cardiac imaging have led to increased identification of hidden CA in patients diagnosed with heart failure. This shift suggests that the actual incidence of CA is underestimated. The prognosis of CA is generally poor, especially in patients with advanced heart failure. However, recent developments in therapeutic interventions have improved the survival of patients with CA. An early diagnosis and interventions involving effective therapies are essential contributors to improved prognoses. Recent noninvasive diagnostic imaging modalities such as echocardiography, cardiac MRI, and nuclear imaging have facilitated the precise and early diagnosis of CA and enabled the initiation of appropriate management. The authors present an updated review of the clinical features of CA, including a discussion of current trends in noninvasive diagnostic imaging. ©RSNA, 2020.
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