Multimodality imaging approach to cardiac amyloidosis: part 2

Area of Science:

• Cardiology
• Medical Imaging

Background:

• Cardiac amyloidosis (CA) is increasingly recognized as a significant contributor to cardiovascular morbidity and mortality.
• CA is an important, often underdiagnosed, cause of heart failure with preserved ejection fraction (HFpEF) and low-gradient aortic stenosis.

Purpose of the Study:

• To review the diagnostic role of various imaging modalities in the comprehensive workup of cardiac amyloidosis.
• To highlight the complementary utility of traditional and advanced cardiac imaging techniques for CA diagnosis.

Main Methods:

• Review of clinical scenarios illustrating the use of electrocardiogram (ECG), echocardiography (echo), cardiac magnetic resonance (CMR), and nuclear cardiac scintigraphy.
• Discussion of the integration of imaging findings with laboratory testing and clinical suspicion.

Main Results:

• Traditional imaging (ECG, echo) and advanced imaging (CMR, nuclear scintigraphy) play complementary roles in CA diagnosis.
• The workup of light chain disease is crucial in the integrated diagnostic approach.

Conclusions:

• A comprehensive diagnostic algorithm integrating clinical suspicion, laboratory tests, and imaging is essential for effective cardiac amyloidosis detection.
• Improved diagnostic strategies can reduce the underdiagnosis of CA and its associated cardiovascular complications.