Cardiac Magnetic Resonance and amyloidosis: Review

Abstract

Amyloidosis is a disease caused by extracellular deposition of insoluble protein fibrils, that results in changes in tissue architecture and consequently modification of the organ structure. Cardiac involvement is common in amyloidosis. Two major types of systemic amyloidosis affect the myocardium-immunoglobulin light chain and transthyretin amyloidosis-each leading to different prognosis. Early detection and diagnosis of cardiac amyloidosis are the main objectives in the assessment of the disease. New techniques of magnetic resonance imaging have minimized the need for biopsies for the diagnosis. Late gadolinium enhancement technique, and more recently T1 mapping, have allowed a simplified evaluation of amyloid deposits and extracellular volume. The aim of this review was to describe basic concepts and updates of the use of magnetic resonance imaging for the diagnosis amyloidosis and evaluation of its severity.

In Vivo Quantification of Myocardial Amyloid Deposits in Patients with Suspected Transthyretin-Related Amyloidosis (ATTR)

“…Modalities used for the diagnosis of cardiac amyloidosis are versatile ranging from electrocardiogram (ECG) and echography to cardiac magnetic resonance (CMR) imaging [9][10][11][12]. The latter visualizes the accumulation of amyloid in the extracellular matrix through an increase of the myocardial extracellular volume (ECV), which can also be quantified as previously described [13][14][15][16][17][18][19]. Despite a high sensitivity and specificity reported for various CMR and echocardiography approaches for the diagnosis of cardiac amyloidosis, their major limitation is the missing molecular information for the differentiation between different types of amyloidosis [16].…”

Characterisation of Hypertrophic Cardiomyopathy by Cardiac Magnetic Resonance Imaging

“…( 16) As described by Rafaela Soler et all, the phenotypic expression of HCM is variable and present in subclinical forms where the LV wall thickness can be < 13mm. The left ventricular wall thickness > 13 mm might develop at latter periods of life in these patients (13). In our study population, most of the patients with HCM had LV wall thickness > 13 mm.…”

Širdies Amiloidozė: Tipai, Epidemiologija, Etiopatogenezė, Ligos Eiga Ir Ištyrimas. Papildomi Diagnostiniai Tyrimai, Jų Ypatumai Ir Prognozė

“…Gadolinio signalo sustiprinimas parodo specifinį vaizdą, pagrįstą miokardo tarpląstelinės erdvės biologinėmis ir tūrio savybėmis. Dėl šios priežasties vėlyvasis gadolinio kontrastavimo ŠMR vaizdas pasirodė esąs veiksmingas širdies amiloidozės nustatymui [24]. Tyrimai parodė, kad kai kurie vėlyvojo gadolinio sustiprinimo modeliai yra labai jautrūs, būdingi ŠA ir netgi gali būti stebimi prieš morfologinį KS storio padidėjimą [13].…”