Imaging-Guided Treatment for Cardiac Amyloidosis

Curr Cardiol Rep. 2022 Jul;24(7):839-850. doi: 10.1007/s11886-022-01703-7. Epub 2022 May 7.

Abstract

Purpose of review: This review will explore the role of cardiac imaging in guiding treatment in the two most commonly encountered subtypes of cardiac amyloidosis (immunoglobulin light-chain amyloidosis [AL] and transthyretin amyloidosis [ATTR]).

Recent findings: Advances in multi-parametric cardiac imaging involving a combination of bone scintigraphy, echocardiography and cardiac magnetic resonance imaging have resulted in earlier diagnosis and initiation of treatment, while the evolution of techniques such as longitudinal strain and extracellular volume quantification allow clinicians to track individuals' response to treatment. Imaging developments have led to a deeper understanding of the disease process and treatment mechanisms, which in combination result in improved patient outcomes. The rapidly expanding treatment regimens for cardiac amyloidosis have led to an even greater reliance on cardiac imaging to help establish an accurate diagnosis, monitor treatment response and aid the adjustment of treatment strategies accordingly.

Keywords: Cardiac amyloidosis; Cardiac magnetic resonance imaging; Echocardiography; Immunoglobulin light chains; Transthyretin.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amyloid Neuropathies, Familial* / pathology
  • Cardiac Imaging Techniques
  • Cardiomyopathies* / diagnostic imaging
  • Cardiomyopathies* / therapy
  • Echocardiography
  • Humans
  • Immunoglobulin Light-chain Amyloidosis* / diagnostic imaging
  • Immunoglobulin Light-chain Amyloidosis* / pathology