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Advanced CMR Techniques in Anderson-Fabry Disease: State of the Art
Andrea Ponsiglione1, Marco De Giorgi1, Raffaele Ascione2
1Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy.
Insights
Anderson-Fabry disease (AFD) is a rare genetic disorder affecting the heart. Advanced cardiac magnetic resonance (CMR) techniques offer new ways to diagnose and predict cardiac complications in AFD patients.
Area of Science:
- Cardiology
- Genetics
- Medical Imaging
Background:
- Anderson-Fabry disease (AFD) is a rare, X-linked lysosomal storage disorder.
- It results from deficient α-galactosidase A enzyme activity.
- Cardiac involvement, including hypertrophy and fibrosis, leads to arrhythmias, valvular issues, and coronary artery disease.
Purpose of the Study:
- To review the role of advanced cardiac magnetic resonance (CMR) techniques.
- To explore their utility as diagnostic and prognostic biomarkers in AFD.
- To highlight CMR's comprehensive assessment capabilities for cardiac involvement.
Main Methods:
- Review of current literature on advanced CMR techniques in AFD.
- Focus on myocardial strain, T1/T2 mapping, perfusion, and hybrid imaging.
- Assessment of CMR's ability to evaluate cardiac anatomy, function, and tissue characteristics.
Main Results:
- Advanced CMR techniques provide detailed insights into cardiac pathology in AFD.
- Myocardial strain, T1/T2 mapping, and perfusion imaging show promise as biomarkers.
- CMR enables comprehensive, noninvasive assessment of cardiac structure and function.
Conclusions:
- Advanced CMR techniques are crucial for diagnosing and monitoring cardiac involvement in AFD.
- These methods offer significant potential as diagnostic and prognostic tools.
- CMR is the leading noninvasive imaging modality for comprehensive cardiac assessment in AFD.
Abstract:
Anderson-Fabry disease (AFD) is a rare multisystem X-linked lysosomal storage disorder caused by α-galactosidase A enzyme deficiency. Long-term cardiac involvement in AFD results in left ventricular hypertrophy and myocardial fibrosis, inducing several complications, mainly arrhythmias, valvular dysfunction, and coronary artery disease. Cardiac magnetic resonance (CMR) represents the predominant noninvasive imaging modality for the assessment of cardiac involvement in the AFD, being able to comprehensively assess cardiac regional anatomy, ventricular function as well as to provide tissue characterization. This review aims to explore the role of the most advanced CMR techniques, such as myocardial strain, T1 and T2 mapping, perfusion and hybrid imaging, as diagnostic and prognostic biomarkers.
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