How to Image Cardiac Amyloidosis: A Practical Approach

JACC Cardiovasc Imaging. 2020 Jun;13(6):1368-1383. doi: 10.1016/j.jcmg.2019.07.015. Epub 2019 Oct 11.

Abstract

Cardiac amyloidosis (CA) is one of the most rapidly progressive forms of heart disease, with a median survival from diagnosis, if untreated, ranging from <6 months for light chain amyloidosis to 3 to 5 years for transthyretin amyloidosis. Early diagnosis and accurate typing of CA are necessary for optimal management of these patients. Emerging novel disease modifying therapies increase the urgency to diagnose CA at an early stage and identify patients who may benefit from these life-saving therapies. The goal of this review is to provide a practical approach to echocardiography, cardiac magnetic resonance, and radionuclide imaging in patients with known or suspected CA.

Keywords: CMR; PET; Tc-99m−PYP; amyloid tracers; cardiac amyloidosis; cardiac magnetic resonance; echocardiography; imaging; multimodality; pyrophosphate; radionuclide imaging.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Amyloid Neuropathies, Familial / diagnostic imaging*
  • Cardiomyopathies / diagnostic imaging*
  • Early Diagnosis
  • Echocardiography*
  • Humans
  • Immunoglobulin Light-chain Amyloidosis / diagnostic imaging*
  • Magnetic Resonance Imaging*
  • Predictive Value of Tests
  • Radionuclide Imaging*
  • Reproducibility of Results

Supplementary concepts

  • Amyloidosis, Hereditary, Transthyretin-Related