Pozo Eduardo, Sanz Javier
The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine, New York, NY, USA.
Expert Rev Cardiovasc Ther. 2014 Oct;12(10):1133-6. doi: 10.1586/14779072.2014.958078. Epub 2014 Sep 10.
The noninvasive diagnosis of cardiac amyloidosis (CA) is often challenging. ECG abnormalities are common but lack both sensitivity and specificity. While some features on transthoracic echocardiography have confirmed the classical picture of CA, they have generally been validated against endomyocardial biopsy and thus are indicative of advanced disease. The ability of cardiac magnetic resonance to characterize the myocardium has opened a new door in the noninvasive diagnosis of CA, representing an opportunity to revisit the role of traditional ECG and transthoracic echocardiography diagnostic crtieria in earlier disease stages.
心脏淀粉样变性(CA)的无创诊断通常具有挑战性。心电图异常很常见,但缺乏敏感性和特异性。虽然经胸超声心动图的一些特征已证实了CA的典型表现,但它们通常是对照心内膜心肌活检进行验证的,因此表明疾病已处于晚期。心脏磁共振成像对心肌进行特征性描述的能力为CA的无创诊断打开了一扇新的大门,这代表了一个重新审视传统心电图和经胸超声心动图诊断标准在疾病早期阶段作用的机会。