Invasive and Non-Invasive Diagnostic Pathways in the Diagnosis of Cardiac Amyloidosis

被引:8
作者
Briasoulis, Alexandros [1 ]
Bampatsias, Dimitrios [1 ]
Papamichail, Adamantia [1 ]
Kuno, Toshiki [2 ]
Skoularigis, John [3 ]
Xanthopoulos, Andrew [3 ]
Triposkiadis, Filippos [3 ]
机构
[1] Natl & Kapodistrian Univ Athens, Alexandra Hosp, Fac Med, Amyloidosis Ctr,Dept Clin Therapeut, 80 Vasilissis Sophias Ave, Athens 11528, Greece
[2] Montefiore Med Ctr, Bronx, NY 10467 USA
[3] Univ Hosp Larissa, Dept Cardiol, Larisa 41110, Greece
关键词
cardiac amyloidosis; diagnosis; AL; ATTR; endomyocardial biopsy; EXTRACELLULAR VOLUME FRACTION; LIGHT-CHAIN AMYLOIDOSIS; SALIVARY-GLAND BIOPSY; AL; PROGNOSIS; STATEMENT; FEATURES; STRAIN;
D O I
10.3390/jcdd10060256
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The appropriate diagnosis and subtyping of cardiac amyloidosis (CA) is frequently missed or delayed due to its vague presentation, clinical overlapping, and diagnostic pitfalls. Recent developments in both invasive and non-invasive diagnostic techniques have significantly changed the diagnostic approach of CA. With the present review, we aim to summarize the current diagnostic approach of CA and to underline the indications of tissue biopsy, either surrogate site or myocardial. The most important factor for timely diagnosis is increased clinical suspicion, especially in certain clinical scenarios. Appropriate imaging with echocardiography or cardiac magnetic resonance (CMR) can provide significant evidence for the diagnosis of CA. Importantly, all patients should undergo monoclonal proteins assessment, with these results significantly determining the steps to follow. A negative monoclonal protein assessment will lead to a non-invasive algorithm which, in combination with positive cardiac scintigraphy, can establish the diagnosis of ATTR-CA. The latter is the only clinical scenario in which the diagnosis can be established without the need of biopsy. However, if the imaging results are negative but the clinical suspicion remains high, a myocardial biopsy should be performed. In the case of the presence of monoclonal protein, an invasive algorithm follows, first by surrogate site sampling and then by myocardial biopsy if the results are inconclusive or prompt diagnosis is needed. The role of endomyocardial biopsy, even though limited by current advances in other techniques, is highly valuable in selected patients and is the only method to reliably establish a diagnosis in challenging cases.
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页数:13
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共 58 条
  • [1] Multi-chamber speckle tracking imaging and diagnostic value of left atrial strain in cardiac amyloidosis
    Aimo, Alberto
    Fabiani, Iacopo
    Giannoni, Alberto
    Mandoli, Giulia Elena
    Pastore, Maria Concetta
    Vergaro, Giuseppe
    Spini, Valentina
    Chubuchny, Vladyslav
    Pasanisi, Emilio Maria
    Petersen, Christina
    Poggianti, Elisa
    Taddei, Claudia
    Castiglione, Vincenzo
    Latrofa, Sara
    Panichella, Giorgia
    Sciaccaluga, Carlotta
    Georgiopoulos, Georgios
    Passino, Claudio
    Cameli, Matteo
    Emdin, Michele
    [J]. EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, 2022, 24 (01) : 130 - 141
  • [2] The Left Ventricular Mass-to-Strain Ratio Enough to Differentiate ATTR From AL Cardiac Amyloidosis?
    Aimo, Alberto
    Castiglione, Vincenzo
    Barison, Andrea
    Chubuchnyi, Vladyslav
    Emdin, Michele
    [J]. JACC-CARDIOVASCULAR IMAGING, 2021, 14 (09) : 1877 - 1878
  • [3] Quantification of Myocardial Extracellular Volume Fraction in Systemic AL Amyloidosis An Equilibrium Contrast Cardiovascular Magnetic Resonance Study
    Banypersad, Sanjay M.
    Sado, Daniel M.
    Flett, Andrew S.
    Gibbs, Simon D. J.
    Pinney, Jennifer H.
    Maestrini, Viviana
    Cox, Andrew T.
    Fontana, Marianna
    Whelan, Carol J.
    Wechalekar, Ashutosh D.
    Hawkins, Philip N.
    Moon, James C.
    [J]. CIRCULATION-CARDIOVASCULAR IMAGING, 2013, 6 (01) : 34 - 39
  • [4] Safety of Right and Left Ventricular Endomyocardial Biopsy in Heart Transplantation and Cardiomyopathy Patients
    Bermpeis, Konstantinos
    Esposito, Giuseppe
    Gallinoro, Emanuele
    Paolisso, Pasquale
    Bertolone, Dario Tino
    Fabbricatore, Davide
    Mileva, Niya
    Munhoz, Daniel
    Buckley, John
    Wyffels, Eric
    Sonck, Jeroen
    Collet, Carlos
    Barbato, Emanuele
    De Bruyne, Bernard
    Bartunek, Jozef
    Vanderheyden, Marc
    [J]. JACC-HEART FAILURE, 2022, 10 (12) : 963 - 973
  • [5] MYOCARDIAL TEXTURE CHARACTERIZATION BY TWO-DIMENSIONAL ECHOCARDIOGRAPHY
    BHANDARI, AK
    NANDA, NC
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1983, 51 (05) : 817 - 825
  • [6] Multiparametric Echocardiography Scores for the Diagnosis of Cardiac Amyloidosis
    Boldrini, Michele
    Cappelli, Francesco
    Chacko, Liza
    Alejandra Restrepo-Cordoba, Maria
    Lopez-Sainz, Angela
    Giannoni, Alberto
    Aimo, Alberto
    Baggiano, Andrea
    Martinez-Naharro, Ana
    Whelan, Carol
    Quarta, Cristina
    Passino, Claudio
    Castiglione, Vincenzo
    Chubuchnyi, Vladyslav
    Spini, Valentina
    Taddei, Claudia
    Vergaro, Giuseppe
    Petrie, Aviva
    Ruiz-Guerrero, Luis
    Monivas, Vanessa
    Mingo-Santos, Susana
    Mirelis, Jesus G.
    Dominguez, Fernando
    Gonzalez-Lopez, Esther
    Perlini, Stefano
    Pontone, Gianluca
    Gillmore, Julian
    Hawkins, Philip N.
    Garcia-Pavia, Pablo
    Emdin, Michele
    Fontana, Marianna
    [J]. JACC-CARDIOVASCULAR IMAGING, 2020, 13 (04) : 909 - 920
  • [7] Amyloid nomenclature 2022: update, novel proteins, and recommendations by the International Society of Amyloidosis (ISA) Nomenclature Committee
    Buxbaum, Joel N.
    Dispenzieri, Angela
    Eisenberg, David S.
    Faendrich, Marcus
    Merlini, Giampaolo
    Saraiva, Maria J. M.
    Sekijima, Yoshiki
    Westermark, Per
    [J]. AMYLOID-JOURNAL OF PROTEIN FOLDING DISORDERS, 2022, 29 (04): : 213 - 219
  • [8] Cardiac amyloidosis presenting with elevations of cardiac troponin I and angina pectoris
    Cantwell, RV
    Aviles, RJ
    Bjornsson, J
    Wright, RS
    Freeman, WK
    Oh, JK
    Hoyer, JD
    Markovic, S
    Jaffe, AS
    [J]. CLINICAL CARDIOLOGY, 2002, 25 (01) : 33 - 37
  • [9] Echocardiographic and Biohumoral Characteristics in Patients With AL and TTR Amyloidosis at Diagnosis
    Cappelli, Francesco
    Baldasseroni, Samuele
    Bergesio, Franco
    Perlini, Stefano
    Salinaro, Francesco
    Padeletti, Luigi
    Attana, Paola
    Perini, Alessandro Paoletti
    Pignone, Alberto Moggi
    Grifoni, Elisa
    Fabbri, Alessia
    Marchionni, Niccolo
    Gensini, Gian Franco
    Perfetto, Federico
    [J]. CLINICAL CARDIOLOGY, 2015, 38 (02) : 69 - 75
  • [10] Use of biomarkers to diagnose and manage cardiac amyloidosis
    Castiglione, Vincenzo
    Franzini, Maria
    Aimo, Alberto
    Carecci, Alessandro
    Lombardi, Carlo Mario
    Passino, Claudio
    Rapezzi, Claudio
    Emdin, Michele
    Vergaro, Giuseppe
    [J]. EUROPEAN JOURNAL OF HEART FAILURE, 2021, 23 (02) : 217 - 230