Diagnostic Tools for Cardiac Amyloidosis: A Pragmatic Comparison of Pathology, Imaging and Laboratories

Curr Probl Cardiol. 2023 May;48(5):101106. doi: 10.1016/j.cpcardiol.2022.101106. Epub 2022 Jan 7.

Abstract

Cardiac amyloidosis (CA) is a complex disease considered to be the most common underdiagnosed form of restrictive cardiomyopathy. Accumulation of misfolded proteins called amyloid fibrils in the extracellular space results in clinical deterioration and late diagnosis is associated with morbidity and mortality. Both types of this disease, light chain CA and transthyretin-related CA share many cardiac and extracardiac features that compromise multiple organs such as kidneys, musculoskeletal system, autonomic nervous system, and gastrointestinal tract. Early diagnosis and detection of CA are imperative. Clinicians should maintain a high degree of suspicion among patients with unexplained diastolic heart failure to implement different disease-altering therapies at the early stages of the disease. In this article, we provided a comprehensive review of multiple invasive and non-invasive cardiac imaging modalities with their respective degrees of sensitivities and specificity.

Publication types

  • Review

MeSH terms

  • Amyloid / metabolism
  • Amyloidosis* / diagnostic imaging
  • Cardiomyopathies* / diagnostic imaging
  • Diagnostic Imaging
  • Heart Failure* / diagnosis
  • Humans
  • Laboratories

Substances

  • Amyloid