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Multimodality imaging approach to cardiac amyloidosis: part 2

Jacqueline Sennott1, Karthikeyan Ananthasubramaniam2

  • 1Heart and Vascular Institute, Henry Ford West Bloomfield Hospital, West Bloomfield, MI, 48322, USA.

Heart Failure Reviews
|October 25, 2021
PubMed

Insights

Cardiac amyloidosis (CA) is an underdiagnosed cause of heart failure. This review details how various imaging techniques, including ECG, echocardiography, MRI, and nuclear scintigraphy, aid in diagnosing CA.

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.

Keywords:
Cardiac amyloidosisCardiac magnetic resonanceEchocardiogramElectrocardiogramLight chain cardiac amyloidosisMultimodality imagingTechnetium-99 m pyrophosphateTransthyretin cardiac amyloidosis

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