Noninvasive imaging in cardiac deposition diseases

Abstract

Infiltrative cardiomyopathy represents a heterogeneous group of diseases of the heart tissue with similar phenotypic expression. The condition is rare, but can be easily mistaken for other more common conditions of the heart. The diagnosis of infiltrative cardiomyopathy is therefore challenging and has often required the use of invasive procedures in the past. In the last decade there have been great advances in non‐invasive cardiac imaging modalities like echocardiography, cardiovascular magnetic resonance and nuclear imaging. Although no single imaging modality abnormality on its own is pathognomic for infiltrative cardiomyopathy, a combination of these different modalities are synergistic, and can greatly aid in the clinical diagnosis. In this review, we describe these advancements in non‐invasive cardiac imaging modalities with a particular focus on cardiovascular magnetic resonance imaging. Level of Evidence: 1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:44–59.

Role of cardiovascular imaging in cancer patients receiving cardiotoxic therapies: a position statement on behalf of the Heart Failure Association (HFA), the European Association of Cardiovascular Imaging (EACVI) and the Cardio‐Oncology Council of the European Society of Cardiology (ESC)

“…Difficulties in nulling the myocardium when defining correct inversion time is another characteristic finding. 128,129 Both types of cardiac amyloidosis significantly increase native T1 relaxation time and extracellular volume, which can be estimated using CMR parametric mapping. 130,131 99m Technetium labelled pyrophosphate ( 99m Tc-PYP) and 3,3-diphosphono-1,2-propanodicarboxic acid ( 99m Tc-DPD) accumulate in the myocardium infiltrated by transthyretin amyloid, whereas hearts with AL deposits demonstrate 18 F-florbetapir uptake, 132,133 with no or minimal 99m Tc-DPD uptake.…”

“…Cardiac magnetic resonance typically demonstrates a combination of global subendocardial, diffuse transmural or patchy late enhancement in a non‐coronary distribution with a dark blood pool. Difficulties in nulling the myocardium when defining correct inversion time is another characteristic finding 128,129 . Both types of cardiac amyloidosis significantly increase native T1 relaxation time and extracellular volume, which can be estimated using CMR parametric mapping 130,131 …”

Correlation between Cardiac Ultrasound Index and Cardiovascular Risk in Healthy Obese and Overweight Populations

“…e enlargement of the LA and RA may be associated with a higher risk of atrial fibrillation in the future [15]. e increase in AO, EDD, MPA, RVOT, IVS, and LVPW may be related to compensatory modifications brought on by the higher cardiac burden associated with obesity, and the increase in these indices is also closely related to the future emergence of structural heart disease [16]. While EF and FS have not yet experienced a significant decrease, the decline in E/A values suggests a decline in early cardiac diastolic function, suggesting that the diastolic function of the heart is primarily impacted in the early stages of obesity or being overweight [17].…”

Cardiovascular magnetic resonance (CMR) in restrictive cardiomyopathies

“…T2* relaxation time is not correlated with serum ferritin levels, although there is a strong correlation with the quantified amount of iron deposition from myocardial biopsy [41]. T2* imaging has also emerged as the best quantitative parameter to guide and assess response to chelation therapy [45] and to monitor disease progression, and is currently the only parametric mapping technique recommended in disease-specific clinical guidelines [46].…”