ISSN: 1885-5857 Impact factor 2023 7.2
Vol. 77. Num. 1.
Pages 79-87 (January 2024)

Review article
Monitoring cardiac amyloidosis with multimodality imaging

Monitorización de la amiloidosis cardiaca con imagen multimodal

Neasa StarrAdam IoannouAna Martinez-Naharro
Imagen extra
Rev Esp Cardiol. 2024;77:79-87
Abstract

Cardiac amyloidosis (CA) refers to an infiltrative process involving amyloid fibril deposition in the myocardium causing restrictive cardiomyopathy. While various types can affect the heart, the predominant forms are immunoglobulin light-chain (AL) amyloidosis and transthyretin (ATTR) amyloidosis. This review article explores the expanding field of imaging techniques used to diagnose AL-CA and ATTR-CA, highlighting their usefulness in prognostication and disease surveillance. Echocardiography is often the initial imaging modality to suspect CA and, since the incorporation of nonbiopsy criteria using bone scintigraphy, diagnosing ATTR-CA has become more attainable following exclusion of plasma cell dyscrasia. Cardiac magnetic resonance is progressively emerging as a vital tool for imaging CA, and is used in diagnosis, prognostication, and disease surveillance. The use of cardiac magnetic resonance in AL-CA is discussed, as it has been shown to accurately evaluate organ response to chemotherapy. As novel drug treatments emerge in the realm of ATTR-CA, the use of cardiovascular imaging surveillance to monitor disease progression is discussed, as it is gaining prominence as a critical consideration. The ongoing phase III trials investigating treatments for patients with ATTR-CA, will undoubtedly enhance our understanding of cardiac imaging surveillance.

Keywords

Cardiac amyloidosis
Cardiac magnetic resonance
Restrictive cardiomyopathy

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