Nuclear imaging of cardiac amyloidosis

Andrikopoulou, Efstathia; Bhambhvani, Pradeep

doi:10.1007/s12350-017-1028-3

Cited by 18 publications

(11 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[27] Developing of modern techniques, such as PET (positron emission tomography) with agents like 18 F-florbetaben shows promising results in evaluating amyloid burden, and distinguish between cardiac amyloidosis types. [13,28,29]…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The role of echocardiography and 99mTc-HDP scintigraphy in non-invasive diagnosis of cardiac amyloidosis

et al. 2019

View full text Add to dashboard Cite

Rationale:Cardiac amyloidosis, considered for the last years to be a rare disease, is one of the determinants of HFpEF. The non-specific clinical presentation and the difficulties related to endomyocardial biopsy have made cardiac amyloidosis an underdiagnosed clinical entity. Improvement of non-invasive diagnostic techniques and the development of new therapies increased clinical awareness for this form of restrictive cardiomyopathy. We here summarize echocardiography and 99mTc-HDP scintigraphy findings in 6 cases of cardiac amyloidosis and review the literature data of this progressive and fatal cardiomyopathy.Patients concerns:The main clinical manifestations were fatigue, low exercise tolerance and edemas. The right heart failure symptoms usually dominated the clinical picture.Diagnoses:All cases were evaluated by echocardiography; 3 cases were further examined by bone scintigraphy and 4 cases a peripheral biopsy was performed. Electrocardiography showed low-voltage QRS complexes and “pseudo-infarct” pattern in the precordial leads, contrary to the echocardiographic aspect, which revealed thickening of ventricle walls. Biatrial dilation and diastolic disfunction were observed. Impaired systolic function was detected in advanced stages of the disease. 99mTc-HDP scintigraphy revealed cardiac uptake of radiopharmaceutical and managed to confirm the diagnosis in 1 case of cardiac amyloidosis in which salivary gland biopsy was negative.Interventions:The treatment was based on managing fluid balance, with the mainstream therapy represented by diuretics. Neurohormonal agents, usually used in heart failure treatment were avoided, due to poor tolerance and worsening of disease course. The management of these 6 cases was challenging due to the refractory manifestation of congestive heart failure.Outcomes:During follow-up, 4 of the 6 patients from the current study died in the first year after the final diagnosis was established.Lessons:Nuclear imaging of cardiac amyloidosis has a revolutionary development nowadays. Bone scintigraphy presents promising results for identifying patients at early stages of disease and to differentiate between cardiac amyloidosis types. Further studies are necessary for the standardization of imaging protocol and development of non-invasive diagnostic tools, especially in assessing the response to treatment and disease progression, for which little is known.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Improvement and standardization of nuclear cardiac imaging techniques, together with the emergence of promising tools such as PET (positron emission tomography) imaging, show promising results in early and specific diagnosis of cardiac amyloidosis. [12,13]…”

Section: Introductionmentioning

confidence: 99%

The role of echocardiography and 99mTc-HDP scintigraphy in non-invasive diagnosis of cardiac amyloidosis

et al. 2019

View full text Add to dashboard Cite

show abstract

“…laikotarpio, atliekant radionuklidų scintigrafiją ir nesant monokloninės imunoglobulinų gamapatijos. Nors tyrimas yra diagnostinis, jis nenurodo paciento prognozės [37]. Tais atvejais, kai šių sąlygų nesilaikoma, reikia atlikti histologinį amiloido patikrinimą, tačiau norint atskirti ATTRwt ir ATTRm širdies amiloidozę, reikia atlikti TTR genotipavimą.…”

Section: Tyrimo Rezultatai Ir Jų Aptarimas Dažniausi šIrdies Amiloidozės Tipaiunclassified

“…Pozitronų emisijos tomografija (PET) suteikia didesnę erdvinę skiriamąją gebą nei kiti branduolinės medicinos vaizdo metodai, tačiau duomenų apie ŠA diagnozę yra mažai. Pradėti kurti hibridiniai PET-MRT skaitytuvai padidins susidomėjimą ŠA tyrimais, naudojant papildomus PET radiofarmpreparatus [37]. Reikėtų toliau tirti PET naudojimą kaip neinvazinę diagnostinę priemonę amiloidozės diagnozei nustatyti.…”

Section: Tyrimo Rezultatai Ir Jų Aptarimas Dažniausi šIrdies Amiloidozės Tipaiunclassified

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

Rėkus¹,

Rėkutė²,

Rėkus³

2021

Health Sciences

View full text Add to dashboard Cite

Širdis, kaip ir bet kuris kūno organas, yra jautrus amiloido kaupimuisi. Nors amiloidozę gali sukelti daugiau nei 30 baltymų rūšių, kliniškai reikšmingos dvi rūšys: lengvųjų grandžių ir transtiretino amiloidozė. Amiloidinė kardiomiopatija paprastai yra pagrindinis ligos baigtį lemiantis veiksnys, o diagnozuoti širdinę amiloidozę dažnai nepakanka įrodymų dėl nespecifinių simptomų ir požymių subklinikinėje stadijoje. Širdies amiloidozės diagnozė dažniausiai patvirtinama atliekant endomiokardo biopsiją, tačiau invazinis būdas susijęs su didesne komplikacijų rizika, todėl ne visada gali būti taikomas klinikinėje praktikoje. Neseniai atsiradus novatoriškiems širdies amiloidozės įvertinimo metodams, neinvaziniai metodai tampa vis svarbesni, ypač siekiant nustatyti ankstyvą diagnozę, tipą, prognozę ir gydymą. Šia literatūros apžvalga siekiama įvertinti naujausius neinvazinius metodus širdies amiloidozei nustatyti, daugiausia dėmesio skiriant ligos eigai ir radiologinei diagnostikai.

show abstract

“…Additionally, SPECT imaging provides limited ability to quantify uptake at affected sites and thus can not be easily used for assessment of disease burden and response to therapy. 16 However, other radiotracers used in positron emission tomography (PET) scanning, such as Pittsburgh compound B ( 11 C-PIB), initially used for imaging bamyloid in Alzheimer's disease, and 18 F-florbetapir, have shown more promise. Both radiotracers bind to amyloid deposits and allow direct imaging of amyloid fibrils.…”

Section: Emerging Nuclear Techniquesmentioning

confidence: 99%