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Imaging Amyloid Tissues Stained with Luminescent Conjugated Oligothiophenes by Hyperspectral Confocal Microscopy and Fluorescence Lifetime Imaging
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Fundamentals of Light Chain Cardiac Amyloidosis: A Focused Review

Azka Latif1, Noman Lateef1, Faryal Razzaq2

  • 1Creighton University Medical Center, Omaha, Nebraska, NE, 68178, United States.

Cardiovascular & Hematological Disorders Drug Targets
|December 1, 2020
PubMed

Insights

Cardiac amyloidosis, a rare condition, is often overlooked in heart failure diagnosis. Early physician education and consideration as a differential diagnosis are crucial for improved patient outcomes.

Area of Science:

  • Cardiology
  • Oncology
  • Pathology

Background:

  • AL amyloidosis affects 8-12 per million in the US, frequently involving the heart.
  • Cardiac involvement in AL amyloidosis leads to poor prognosis despite advanced treatments.
  • It's often missed as a cause of heart failure with preserved ejection fraction, delaying diagnosis and treatment.

Purpose of the Study:

  • To review advances in diagnosing and managing cardiac amyloidosis.
  • To educate primary care physicians on recognizing and managing this condition.
  • To emphasize cardiac amyloidosis as a critical differential diagnosis for heart failure.

Main Methods:

  • Review of pathogenesis, association with plasma cell dyscrasias.
  • Summary of novel diagnostic techniques: echocardiography, cardiac MRI, histopathology, biomarkers.
  • Overview of treatment strategies: supportive care, chemotherapy, palliative care.

Main Results:

  • AL amyloidosis diagnosis is often delayed due to its subtle presentation.
  • Multisystem involvement is common, impacting prognosis.
  • Current management strategies offer limited survival benefits, highlighting the need for early intervention.

Conclusions:

  • Physician education is vital to improve early diagnosis of cardiac amyloidosis.
  • A comprehensive diagnostic approach including imaging and biomarkers is recommended.
  • Integrated care, including palliative and hospice options, is essential for managing this poor-prognosis disease.

Keywords:
Cardiac amyloidosisamyloid precursorschemotherapyheart failurelight chain amyloidosismanagement and diagnosis of amyloidosistransthyretin amyloidosis

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